Top Line: Black men are underrepresented in clinical trials of PSA screening for prostate cancer.
The Study: In the classic PLCO trial, for example, <5% of participants were Black. This large, retrospective cohort study from the VA sought to determine the prostate cancer mortality benefit of PSA screening in a much more racially diverse population. It included >45,000 men diagnosed with prostate cancer with a whopping 31% that were non-Hispanic Black. Across the study period, 5.4% died of prostate cancer and 4.4% died of other causes. The rate of PSA screening (as a continuous variable) prior to diagnosis was independently associated with a reduced risk of prostate cancer specific mortality (PCSM). Black men derived just as much benefit as White men from PSA screening (HR 0.56 v 0.58). Among Black men who had screening, the cumulative incidence of PCSM was lower in those who had annual screening compared to those who had less than annual screening (4.7% v 7.3%). That difference was not observed among White men. This suggests Black men may benefit from more intensive (at least annual) PSA screening.
TBL: This large VA study suggests Black men benefit just as much as White men from PSA screening with a significant reduction in the risk of PCSM. | Sherer, JAMA Oncol 2022