Earlier prostate-specific antigen testing in African American men—Clinical support for the recommendation

Saltzman, Amanda F.; Luo, Suhong; Scherrer, Jeffrey F.; Carson, Kenneth; Grubb, Robert L.; Hudson, M’Liss A.

doi:10.1016/j.urolonc.2015.03.018

Cited by 14 publications

(10 citation statements)

References 36 publications

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“…It has been shown that African Americans have higher PSA levels in cancerous tumors [ 14 , 31 – 35 ]. Even in non-cancerous prostates, African Americans have higher PSA levels [ 13 , 36 ]. Furthermore, a large national cohort study found that African American veterans aged 40–54 were more likely to have 3 or more positive core biopsies yet they were less likely to be actively surveilled when compared to their white counterparts [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…Even in non-cancerous prostates, African Americans have higher PSA levels [ 13 , 36 ]. Furthermore, a large national cohort study found that African American veterans aged 40–54 were more likely to have 3 or more positive core biopsies yet they were less likely to be actively surveilled when compared to their white counterparts [ 36 ]. Indeed, African American veterans, aged 55–70, were more likely to have a higher grade and stage prostate cancer than African American veterans aged 40–54 [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

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Do African-American men need separate prostate cancer screening guidelines?

et al. 2016

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BackgroundIn 2012, the United States Preventative Services Task Force issued new guidelines recommending that male U.S. residents, irrespective of race, no longer be screened for prostate cancer. In African American men, the incidence of prostate cancer is almost 60 % higher and the mortality rate is two to three times greater than in Caucasians. The purpose of this study is to reduce African American men's prostate cancer burden by demonstrating they need separate screening guidelines.MethodsWe performed a PubMed search using the keywords: African American, Prostate cancer, Outcomes, Molecular markers, Prostate-specific Antigen velocity, PSA density, and to derive data relevant to our hypothesis.ResultsIn our literature review, we identified several aspects of prostate cancer that are different in Caucasian and African American men. These included prostate cancer incidence and outcome, the clinical course of the disease, serum PSA levels, genetic differences, and social barriers. It's also important to note that the USPSTF guidelines were based on two studies, one of which reported that only 4 % of its participants were African American. The other did not report demographic information, but used participants from seven European countries with small African American populations.ConclusionGiven the above, we conclude that separate prostate cancer screening guidelines are greatly necessary to help save the lives of African Americans.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Do African-American men need separate prostate cancer screening guidelines?

et al. 2016

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“…In light of the disproportionately high disparities in PCa incidence and mortality affecting AA/Black men, recent recommendations espouse earlier screening for this group ( American Cancer Society, 2017 ; Powell et al, 2014 ; Saltzman et al., 2015 ). USPSTF guidelines are also currently undergoing a process of revision ( U.S. Preventive Services Task Force, 2017 ), although a full recommendation statement has not been finalized.…”

Section: Discussionmentioning

confidence: 99%

“…PCa diagnosis involves prostate-specific antigen (PSA) screening ( American Academy of Family Physicians, 2017 ; American Cancer Society, 2017 ; Halbert et al, 2017 ; Han et al, 2013 ; Moyer, 2012 ; Powell, Vigneau, Bock, Ruterbusch, & Helibrun, 2014 ; Saltzman et al, 2015 ; Shen & Kumar, 2016 ; Siegel et al, 2017 ). Circulating serum PSA levels are considered abnormal when detected above 4 ng/ml ( American Academy of Family Physicians, 2017 ; Moyer, 2012 ).…”

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confidence: 99%

“…A more recent study that used Surveillance, Epidemiology, and End Results (SEER) data to investigate survival disparities between AA ( n = 23,782) and EA ( n = 188,937) men comparing pre-PSA testing era to current-PSA testing era provided a compelling case for continued aggressive PSA testing for AA men ( Powell et al, 2014 ). Additionally, frequent and early PSA testing has been suggested for AA men in order to reduce racial disparities in PCa mortality ( Powell et al, 2014 ; Saltzman et al., 2015 ).…”

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confidence: 99%

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Physician Consultations, Prostate Cancer Knowledge, and PSA Screening of African American Men in the Era of Shared Decision-Making

et al. 2018

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African American (AA)/Black men are more likely to develop aggressive prostate cancer (PCa), yet less likely to be screened despite guidelines espousing shared decision-making regarding PCa screening and prostate-specific antigen (PSA) testing. Given the documented racial disparities in PCa incidence and mortality, engaging interactions with physicians are especially important for AA/Black men. Thus, this study evaluated occurrence of physician–patient conversations among AA/Black men, and whether such conversations were associated with PCa knowledge. We also quantified the serum PSA values of participants who had, and had not, discussed testing with their physicians. Self-identified AA/Black men living in California and New York, ages 21–85, donated blood and completed a comprehensive sociodemographic and health survey (n = 414). Less than half (45.2%) of participants had discussed PCa screening with their physicians. Multivariate analyses were used to assess whether physician–patient conversations predicted PCa knowledge after adjusting for key sociodemographic/economic and health-care variables. Increased PCa knowledge was correlated with younger age, higher income and education, and having discussed the pros and cons of PCa testing with a physician. Serum PSA values were measured by ELISA. Higher-than-normal PSA values were found in 38.5% of men who had discussed PCa screening with a physician and 29.1% who had not discussed PCa screening. Our results suggest that physician–AA/Black patient conversations regarding PCa risk need improvement. Encouraging more effective communication between physicians and AA/Black men concerning PCa screening and PSA testing has the potential to reduce PCa health disparities.

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