A new study indicates that higher prostate cancer death rates among black men in the US may be due to a higher risk of developing preclinical prostate cancer as well as a higher risk of that cancer progressing more quickly to advanced stages. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study suggests that screening policies may need to be tailored to the higher-risk status of this population.
Among black men in the United States, the incidence of prostate cancer is 60 percent higher than that of white men, and their mortality rate from prostate cancer is more than twice as high. To understand why, a team from the Fred Hutchinson Cancer Research Center, the University of Michigan, and Erasmus University in the Netherlands used three models of prostate cancer incidence and prostate specific antigen (PSA) screening in the United States to estimate disease onset and progression based on prostate cancer data from 1975-2000 reported by the Surveillance, Epidemiology, and End Results program of the National Cancer Institute.
In an accompanying editorial, IHPI member Lauren Wallner, PhD, MPH, and Steven Jacobsen, MD, PhD, of Kaiser Permanente Southern California, noted that the study's findings imply that the risk/benefit trade-offs of PSA screening may be quite different for black men when compared with the general population. "As the evidence is accumulating that a 'one size fits all' screening approach to prostate cancer may not be what is most appropriate, it may be time for the conversation around PSA screening to really focus on more personalized approaches to screening in high-risk black men," they wrote.