Association between PSA screening and prostate cancer mortality among non-Hispanic Black and non-Hispanic White US veterans

Black men have higher prostate cancer incidence and mortality than non-Hispanic white men. However, Black men have been underrepresented in clinical trials of PSA screening; therefore, there is a lack of data to guide screening recommendations for this population.

The objective of this study is to assess whether PSA screening is associated with reduced risk of prostate cancer-specific mortality among non-Hispanic Black men. This retrospective cohort study used data from the US Veterans Health Administration for men aged 55 to 69 years who self-identified as non-Hispanic Black or non-Hispanic White and were diagnosed with intermediate-, high-, or very high-risk prostate cancer from January 1, 2004-December 31, 2017.

 This study included 45,834 veterans with a mean age of 62.7 years of whom 14,310 (31%) were non-Hispanic Black men and 31,254 (69%) were non-Hispanic White men. The PSA screening rate was associated with a lower risk of prostate cancer specific mortality among Black men and White men. In subset analysis, annual screening (vs some screening) was associated with a significant reduction in risk of prostate cancer specific mortality among Black men, but not among White men. This suggests that annual screening may be particularly important for Black men. Further research is needed to identify appropriate populations and protocols to maximize the benefits of PSA screening.

Jama Oncology. 2022 Aug; doi:10.1001/jamaoncol.2022.2970