Black Men Face Increased Risk of Overdiagnosis from Common Prostate Cancer – A study suggests that the widely used prostate-specific antigen (PSA) test may lead to overdiagnosis in black men, potentially influencing prostate cancer diagnosis. The research, conducted by the University of Exeter, found that black men have higher PSA levels than white men and Asian men, leading to more diagnoses of prostate cancer after a raised PSA result. Despite similar levels of advanced prostate cancer between black and white men, the higher PSA levels in black men may contribute to increased diagnoses. This disparity highlights the need for more precise and accurate prostate cancer diagnosis to avoid unnecessary biopsies that can lead to psychological distress and sepsis.
The impact of intensifying prostate cancer screening in black men is also under scrutiny. While studies show parity in survival between black and white men with prostate cancer, black men often present with more advanced disease at younger ages. Intensifying screening through more frequent PSA testing and biopsies for abnormal results aims to maximize early cancer detection but raises concerns about overdiagnosis. Efforts to achieve equity in racial outcomes must consider both the benefits and potential harms of intensified screening strategies.
About the research
A new study by the University of Exeter suggests that the widely used PSA test for prostate cancer may lead to overdiagnosis in Black men.
PSA testing is a blood test commonly used in the UK as an initial step to investigate men with urinary symptoms or those over 50 requesting the test. The study, published in BMC Medicine, aimed to understand the test’s effectiveness in identifying prostate cancer across different ethnicities.
While Black men in the UK are more likely to be diagnosed, it’s unclear if their outcomes differ from White men. The research, funded by various organizations, analyzed data from over 730,000 men to assess cancer diagnoses following PSA tests.
Key findings
Over 80% of all men, regardless of ethnicity, had normal PSA levels.
Black men had higher average PSA levels compared to White and Asian men.
Black men had the highest rate of cancer diagnoses following a raised PSA test.
Rates of advanced prostate cancer were similar between Black and White men, suggesting higher PSA levels might influence diagnosis in Black men.
Concerns and implications
PSA testing has faced criticism as only one-third of men with a positive test have cancer, while one in seven with the disease have normal PSA levels.
This study suggests Black men may undergo unnecessary diagnostic procedures like biopsies due to naturally higher PSA levels.
Under-representation of Black, Asian, and other minority groups in cancer research raises concerns about the accuracy of findings informing PSA testing and diagnosis for these groups.
In summary, the research underscores the importance of tailored approaches to prostate cancer screening, especially for black men who may be at a higher risk of overdiagnosis due to their naturally elevated PSA levels. Balancing the benefits of early detection with the risks of overdiagnosis is crucial in ensuring optimal care for all individuals, regardless of ethnicity.
What are the treatment options for prostate cancer?
Treatment options for prostate cancer include:
- Active Surveillance: Monitoring the cancer without immediate treatment, suitable for early-stage, slow-growing tumors.
- Surgery: Removal of the prostate (radical prostatectomy) or part of the prostate (transurethral resection of the prostate, TURP).
- Radiation Therapy: External beam radiation therapy or brachytherapy (implanting radioactive seeds into the prostate).
- Hormone Therapy: Reducing testosterone levels to slow cancer growth, using medications like LHRH agonists, anti-androgens, or orchiectomy.
- Chemotherapy: Using drugs to kill cancer cells, often used for advanced or metastatic prostate cancer.
Immunotherapy: Boosting the immune system to fight cancer, such as sipuleucel-T.
Targeted Drug Therapy: Treating specific molecular targets in cancer cells.
Bone-Modifying Drugs: Preventing bone fractures in patients with metastatic prostate cancer.
Cryotherapy: Freezing and destroying cancer cells.
High-Intensity Focused Ultrasound (HIFU): Using ultrasound energy to heat and destroy cancer cells.
Clinical Trials: Testing new treatments not yet available to the public.
The choice of treatment depends on the stage of the cancer, the patient’s overall health, and personal preferences. Discuss the options with your healthcare team to determine the best course of action.
After reading Black Men Face Increased Risk of Overdiagnosis from Common Prostate Cancer, ALSO READ: Can Unhealthy Eating Lead To Chronic Pain?
What are the symptoms of prostate cancer?
Prostate cancer symptoms are often not present in the early stages, but as the cancer progresses, some men may experience the following:
- Urinary symptoms:
- Frequent urination, especially at night
- Difficulty starting urination or holding back urine
- Weak or interrupted urine flow
- Painful or burning urination
- Blood in the urine
- Erectile and ejaculatory symptoms:
- Difficulty achieving or maintaining an erection
- Painful ejaculation
- Blood in the semen
- Decreased volume of ejaculation
- Lower extremity symptoms:
- Frequent pain or stiffness in the lower back, hips, or upper thighs
- Swelling in the lower extremities
Other symptoms:
- Bone pain and swelling in the lower extremities
- Unexplained weight loss
- Fatigue
- Change in bowel habits
- Keep in mind that these symptoms may be caused by conditions other than prostate cancer. If you experience any of these symptoms, consult your doctor for a thorough work-up to determine the underlying cause
