A study published in JAMA Oncology found that prostate cancer-specific mortality (PCSM) risk was significantly reduced among Black men who received annual prostate-specific antigen (PSA) screening.
Randomized clinical trials evaluating the efficacy of PSA screening are limited and in general, Black men are underrepresented in published trials. To address the paucity of data, this study sourced data from the US Veterans Health Administration Informatics and Computing Infrastructure. The study included 45,834 men aged 55 to 69 years who were at intermediate to very high risk for prostate cancer using National Comprehensive Cancer Network (NCCN) criteria between 2004 and 2017. The primary endpoint was PCSM rate related with PSA screening in the 5 years prior to prostate cancer diagnosis.
The mean age within the study cohort was 62.7 years, 31% were Black, and 69% were White.
The rate of any PSA screening was 28.6% among White men and 29.6% among Black men and the annual rate was 9.9% and 9.4%, respectively.
At diagnosis, Black men had higher PSA levels than White men (mean, 15.1 vs 13.0 ng/mL; P =.001).
Stratified by screening frequency, at 120 months the cumulative PCSM incidence was 4.7% for annual screening and 7.3% for some screening in the Black cohort. In the White cohort, the cumulative PCSM rate was 5.9% for annual screening and 6.9% for some screening.
Annual screening significantly decreased PCSM risk among Black men (subdistribution hazard ratio [sHR], 0.65; 95% CI, 0.46-0.92; P =.02) but not among White men (aHR, 0.91; 95% CI, 0.74-1.11; P =.35).
These data may not be generalizable, as Veterans have differing prostate cancer outcomes compared with the general population.
The study authors concluded that annual PSA screening reduced the PCSM rate among Black men.
Sherer MV, Qiao EM, Kotha NV, Qian AS, Rose BS. Association between prostate-specific antigen screening and prostate cancer mortality among non-Hispanic Black and non-Hispanic White US veterans. JAMA Oncol. Published online August 4, 2022. doi:10.1001/jamaoncol.2022.2970