Disparities/Minority Health

Blacks have longer PSA screening intervals than whites

A larger proportion of black men suffer from prostate cancer and die of the disease than white men. An important way to diagnose prostate cancer is to monitor a man's prostate-specific antigen (PSA) levels. Researchers have now found that blacks diagnosed with prostate cancer are more likely than whites to have a longer interval between PSA screenings. For this study, the researchers analyzed Medicare data on 18,067 black (15.8 percent) and white men (84.2 percent) aged 65 or older. All had been diagnosed with prostate cancer between 1994 and 2002. Tumor stage at diagnosis was considered the primary study outcome. The researchers also determined the time since last PSA test.

More white men (46.1 percent) than black men (40.4 percent) had undergone PSA testing within the year before their diagnosis of prostate cancer. Compared with whites, blacks were more likely to have had no PSA testing prior to their diagnosis (32.8 percent vs. 22.1 percent). Men with advanced-stage tumors were more likely not to have had a PSA test prior to diagnosis. They were also less likely to have had the test within a year of being diagnosed.

The researchers found an association between longer intervals between PSA tests and the likelihood of advanced disease. In this study, blacks were less likely to be married, had lower educational levels, and lower household incomes than whites. They were also more likely than whites to have one or more medical conditions and less likely to report urinary symptoms at the time of their last PSA test. According to the researchers, some of the racial disparity observed with prostate cancer may be reduced by more frequent and systematic PSA screening. The study was supported in part by the Agency for Healthcare Research and Quality (HS13353).

See "Racial differences in PSA screening interval and stage of diagnosis," by William R. Carpenter, Ph.D., Daniel L. Howard, Ph.D., Yhenneko J. Taylor, M.S., and others in Cancer Causes Control 21, pp. 1071-1080, 2010.

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