Even with the same prostate-specific antigen (PSA) levels, Black men are more likely to have prostate cancer than white men, new research shows.

The findings point to the need for earlier and more frequent screening, the researchers noted.

It’s already known that Black men in the United States are more likely to develop prostate cancer than their white peers. After diagnosis, they’re also more likely to have advanced disease and to die.

The new research suggests that at any PSA level, Black men are more likely to harbor prostate cancer than white men.

The research included more than 75,000 Black men and more than 207,000 white men who were receiving care from the U.S. Department of Veterans Affairs (VA).

The researchers used modeling to predict the likelihood of prostate cancer diagnosis from a first biopsy.

Prostate cancer was detected in the first biopsy in 55% of Black men and in 43% of white men, the investigators found.

After accounting for other factors, Black veterans were 50% more likely to receive a prostate cancer diagnosis based on their first prostate biopsy than white Veterans were, according to the report published online Nov. 6 in the journal CANCER

Black men with a pre-biopsy PSA of 4.0 ng/mL had a 49% risk of prostate cancer detected during their biopsy. This compared to a 39% risk for white men with the same PSA level.

Even worse, Black veterans with a PSA of 4.0 ng/mL had an equivalent risk of prostate cancer as white Veterans with a PSA of 13.4 ng/mL, the findings showed.

“These findings suggest that to reduce health disparities for veterans in the prevention of prostate cancer, clinicians should consider an individual veteran’s risk for prostate cancer including factors such as race and age,” said first study author Kyung Min Lee, of the VA Informatics and Computing Infrastructure within the VA Salt Lake City Health Care System.

“Clinicians may consider earlier screening for populations at greater than average risk, which includes Black men,” he added in a journal news release.

The VA recommends that, for average risk men aged 55 to 69 years, any decision to initiate or continue prostate cancer screening with PSA should be individualized, said Dr. Jane Kim, executive director for Preventive Medicine in the VA.

“This includes consideration of age, family history, race/ethnicity, medical conditions, and patient values, as well as potential benefits versus harms,” Kim added.

“Per the U.S. Preventive Services Task Force, before deciding whether to be screened, men should have an opportunity to discuss the benefits and harms of screening through shared decision making with their clinicians,” Kim advised.

More information

The U.S. National Cancer Institute has more on prostate cancer.

SOURCE: CANCER, news release, Nov. 6, 2023