NEJM Evid
Prostate Cancer Foundation: Screening guidelines for Black men in the U.S.
May 21, 2024
![card-image](https://cdn.epocrates.com/specialty/fhevtoe66bch/7wQnWHYSv6mpK9t5rdk6Pz/aab59fa8dfa9d375bb34126fe49db9b8/Shutterstock_2283175533__2_.jpg)
These guidelines recommend that Black men should receive information about PSA screening for prostate cancer. Among Black men who elect screening, baseline PSA testing should occur between ages 40 and 45. Annual screening should be strongly considered depending on PSA value and health status.
- Of 1,848 publications screened, 287 studies were selected for full-text review, and 264 formed the basis for these guidelines. Three RCTs provided Level 1 evidence that regular PSA screening of men ages 50 to 74 of average risk reduced metastasis and prostate cancer death at 16 to 22 years of follow-up.
- Cohort studies suggest that discussions about baseline PSA testing between Black men and their clinicians should start in the early 40s, and data from modeling studies indicate prostate cancer develops 3 to 9 years earlier in Black men compared with non-Black men.
- Lowering the age for baseline PSA testing to 40 to 45 years from 50 to 55 years, followed by regular screening until 70 (informed by PSA values and health factors), could reduce prostate cancer mortality in Black men (~30% relative risk reduction) without substantially increasing overdiagnosis.
Source:
Garraway I, et al. (2024, April 23). NEJM Evid. Prostate Cancer Foundation Screening Guidelines for Black Men in the United States. https://evidence.nejm.org/doi/abs/10.1056/EVIDoa2300289
TRENDING THIS WEEK