Recent News and Articles on the Keywords: prostate + benefits + screening  Related to the article below (Last Update: 8/7/2008)

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Prostate Screening Benefits African-Americans

The American Cancer Society (ACS) recommendation to begin prostate cancer screening at a younger age in African-American men appears to be paying off. A study published in the Journal of Radiation Oncology Biology Physics (Vol. 57, No. 5: 1292-1296) suggests more African-American men have been diagnosed with earlier stage disease since 1997, when the recommendation was first made.

Prostate cancer is the most common cancer in American men, striking nearly 221,000 each year, and killing nearly 29,000. African-American men are more likely to develop the disease, and they tend to develop it younger and in more aggressive forms than men of other races.

For these reasons, ACS recommends that African-American men begin screening at age 45, or even younger if they have several relatives who have had prostate cancer. (For men at average risk, doctors are advised to offer screening and to discuss the benefits and limitations of testing and treatment beginning at age 50.)

Screening can detect prostate cancer at an early stage, when it is easier to treat. Men are given a blood test for prostate-specific antigen, or PSA, as well as a digital rectal exam (DRE). A normal PSA level is typically under 4 nanograms per milliliter (ng/mL) of blood. A man with a PSA between 4 and 10 has about a 25% chance of having prostate cancer, while a man with a PSA over 10 has about a 67% chance of having prostate cancer.

Previous studies have shown that African-American men tend to have higher PSA levels than white men when they are diagnosed with prostate cancer, meaning their disease is likely more advanced when it is found. Researchers from the University of Michigan wanted to compare PSA levels at diagnosis in white and African-American men, and see if those levels changed after the screening guideline was revised.

They studied more than 2,000 men who had been diagnosed with prostate cancer during two time periods: 1990-1996, before earlier screening was recommended; and 1997-2001, after the guideline was revised.

In both time periods, African-American men had higher PSA levels than white men at diagnosis, but the difference shrank over time. In the first period, black men had PSA levels 36% higher than whites; in the second period, their levels were just 13% higher.

That shift suggests more African-American men were being screened in the second period -- and thus, being diagnosed at an earlier stage of disease -- rather than getting the PSA test because they had disease advanced enough to cause symptoms, said lead researcher Charlie Pan, MD, a radiation oncologist at the University of Michigan.

The African-American men were also younger than the white men when they were diagnosed, and that gap widened over time, from 2.5 years in the first period to more than 3 years in the second period.

"The racial differences in initial PSA levels observed in the study suggest that African-American men are more susceptible at an earlier age to [prostate cancer] and should continue to be screened at a younger age than Caucasians, as recommended by the American Cancer Society in its screening guidelines," Pan said.

Durado Brooks, MD, director of prostate and colorectal cancer for ACS, said the new study reinforces the idea that PSA screening leads to earlier stage at diagnosis.

"It does appear that [screening] is benefiting African-American men at least to the same degree that it's benefiting Caucasian men," he said. "African-American men are being diagnosed at an earlier stage of disease, which hopefully means that their outcomes related to treatment will also improve."