Earlier prostate cancer screening supported for black men

In 1997, the American Cancer Society released guidelines recommending early prostate cancer screening for certain high-risk groups, including black men. Now, new research indicates that since their release the racial gap in disease stage at diagnosis has narrowed.

The findings, which are reported in the December issue of the International Journal of Radiation Oncology Biology Physics, are based on a study of 2332 men with prostate cancer who seen at a university hospital or its community affiliates between 1990 and 2001. Of these patients, 1968 were white and 364 were black.From 1990 to 1996, the expected average initial PSA for black patients was 14.6, much higher than the value of 10.5 for whites, lead author Dr. Charlie C. Pan and colleagues, from the University of Michigan at Ann Arbor, report.In the period after the ACS guidelines were published, the racial difference in initial PSA, although still statistically significant, was less pronounced. This was due to a 3.8-point fall in the initial PSA for blacks that outpaced the 1.0 drop seen in whites. During both time periods, blacks were diagnosed at a significantly younger age than whites.Regardless of race, T stage distributions improved between the pre- and post-guideline periods, the authors note. In contrast, Gleason score distributions were unchanged.”The overall decline in initial PSA levels in both racial groups is good news as it shows that patients have become more aware of the disease and are coming to us when their cancer is most treatable,” Dr. Pan said in a statement. “The racial differences in initial PSA levels observed in the study prove that African-American men are susceptible at an earlier age to this disease and should continue to be screened at a younger age than Caucasians, as recommended by the ACS,” he added.(Source: Int J Radiat Oncol Biol Phys 2003;57:1292-1296: Reuters Health: December 29, 2003: Oncolink)