Prostate cancer screening is better than originally thought, especially for Black men, study says

A blood test to screen for prostate cancer may be better at doing so than experts originally thought, particularly among Black men. There’s no standard test for prostate cancer. Two of the more commonly used tests are a digital rectal exam and a blood test for prostate specific antigen (PSA), an enzyme that is typically higher in men with prostate cancer.

A study published Sunday in the New England Journal of Medicine Evidence looked at how successful the blood tests were for all races, and specifically for Black men, by estimating how often these tests led to over overdiagnosis and overtreatment. The researchers looked at three decades of records through 2016, the last year records were available.

Not only was the test more effective than scientists originally thought, the study determined that the net benefit is even better for Black men than for the general population.

One death was prevented for every 11 to 14 men of all races diagnosed with cancer, the study says. Among Black men, the test prevented 1 death for every 8 to 12 men diagnosed and 1 death for every 5 to 9 men treated for prostate cancer.

With the rise in testing in the late 1980s, there was a trend to treat tumors that weren’t a real threat like the ones that were. More recently, for tumors that don’t show a risk of progression, doctors have taken more of an active surveillance approach.

Prostate cancer is the second leading cause of cancer death in American men, behind lung cancer. Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and 2 or 3 men will die from prostate cancer.

Black men have nearly double the risk of prostate cancer death than the general population. They also get prostate cancer more often. But Black men have been historically underrepresented in clinical trials that look at the success rate of tests and other diagnostic tools.

Studies showed that the decision was based on some studies that didn’t fully capture the benefit of screening. The USPSTF updated their recommendation to a grade C, meaning that patients should discuss such screening with their doctors. Many of the other guidelines have been unclear about whether a patient should go through PSA screening.

Depending on a person’s risk that the cancer could spread, they may be monitored closely with regular MRIs and biopsies rather than getting treatments like surgery and radiation. They will have an ongoing conversation with their doctor about how to manage the disease.

This study should actually encourage more folks to be screened. These days, you have a lot more ability to make a more nuanced and thoughtful decision with your doctor about whether you will be treated or not for prostate cancer.

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