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Prostate Cancer Foundation Screening Guidelines for Black Men in the United States

Garraway, Isla P. ; Carlsson, Sigrid V. LU ; Nyame, Yaw A. ; Vassy, Jason L. ; Chilov, Marina ; Fleming, Mark ; Frencher, Stanley K. ; George, Daniel J. ; Kibel, Adam S. and King, Sherita A. , et al. (2024) In NEJM Evidence 3(5).
Abstract

BACKGROUND In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer. Given this disparity, we examined relevant data to establish clinical prostate-specific antigen (PSA) screening guidelines for Black men in the United States. METHODS A comprehensive literature search identified 1848 unique publications for screening. Of those screened, 287 studies were selected for full-text review, and 264 were considered relevant and form the basis for these guidelines. The numbers were reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Three randomized controlled trials provided Level 1 evidence that regular PSA screening of men 50... (More)

BACKGROUND In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer. Given this disparity, we examined relevant data to establish clinical prostate-specific antigen (PSA) screening guidelines for Black men in the United States. METHODS A comprehensive literature search identified 1848 unique publications for screening. Of those screened, 287 studies were selected for full-text review, and 264 were considered relevant and form the basis for these guidelines. The numbers were reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Three randomized controlled trials provided Level 1 evidence that regular PSA screening of men 50 to 74 years of age of average risk reduced metastasis and prostate cancer death at 16 to 22 years of follow-up. The best available evidence specifically for Black men comes from observational and modeling studies that consider age to obtain a baseline PSA, frequency of testing, and age when screening should end. Cohort studies suggest that discussions about baseline PSA testing between Black men and their clinicians should begin in the early 40s, and data from modeling studies indicate prostate cancer develops 3 to 9 years earlier in Black men compared with non-Black men. Lowering the age for baseline PSA testing to 40 to 45 years of age from 50 to 55 years of age, followed by regular screening until 70 years of age (informed by PSA values and health factors), could reduce prostate cancer mortality in Black men (approximately 30% relative risk reduction) without substantially increasing overdiagnosis. CONCLUSIONS These guidelines recommend that Black men should obtain information about PSA screening for prostate cancer. Among Black men who elect screening, baseline PSA testing should occur between ages 40 and 45. Depending on PSA value and health status, annual screening should be strongly considered. (Supported by the Prostate Cancer Foundation.).

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publishing date
type
Contribution to journal
publication status
published
subject
in
NEJM Evidence
volume
3
issue
5
publisher
Massachusetts Medical Society
external identifiers
  • scopus:105024807696
ISSN
2766-5526
DOI
10.1056/EVIDoa2300289
language
English
LU publication?
yes
additional info
Publisher Copyright: Copyright © 2024 Massachusetts Medical Society. All rights reserved.
id
4c414921-6125-48ba-a6d5-c511a02e39f1
date added to LUP
2026-03-05 16:35:09
date last changed
2026-03-30 13:49:01
@article{4c414921-6125-48ba-a6d5-c511a02e39f1,
  abstract     = {{<p>BACKGROUND In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer. Given this disparity, we examined relevant data to establish clinical prostate-specific antigen (PSA) screening guidelines for Black men in the United States. METHODS A comprehensive literature search identified 1848 unique publications for screening. Of those screened, 287 studies were selected for full-text review, and 264 were considered relevant and form the basis for these guidelines. The numbers were reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Three randomized controlled trials provided Level 1 evidence that regular PSA screening of men 50 to 74 years of age of average risk reduced metastasis and prostate cancer death at 16 to 22 years of follow-up. The best available evidence specifically for Black men comes from observational and modeling studies that consider age to obtain a baseline PSA, frequency of testing, and age when screening should end. Cohort studies suggest that discussions about baseline PSA testing between Black men and their clinicians should begin in the early 40s, and data from modeling studies indicate prostate cancer develops 3 to 9 years earlier in Black men compared with non-Black men. Lowering the age for baseline PSA testing to 40 to 45 years of age from 50 to 55 years of age, followed by regular screening until 70 years of age (informed by PSA values and health factors), could reduce prostate cancer mortality in Black men (approximately 30% relative risk reduction) without substantially increasing overdiagnosis. CONCLUSIONS These guidelines recommend that Black men should obtain information about PSA screening for prostate cancer. Among Black men who elect screening, baseline PSA testing should occur between ages 40 and 45. Depending on PSA value and health status, annual screening should be strongly considered. (Supported by the Prostate Cancer Foundation.).</p>}},
  author       = {{Garraway, Isla P. and Carlsson, Sigrid V. and Nyame, Yaw A. and Vassy, Jason L. and Chilov, Marina and Fleming, Mark and Frencher, Stanley K. and George, Daniel J. and Kibel, Adam S. and King, Sherita A. and Kittles, Rick and Mahal, Brandon A. and Pettaway, Curtis A. and Rebbeck, Timothy and Rose, Brent and Vince, Randy and Winn, Robert A. and Yamoah, Kosj and Oh, William K.}},
  issn         = {{2766-5526}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{Massachusetts Medical Society}},
  series       = {{NEJM Evidence}},
  title        = {{Prostate Cancer Foundation Screening Guidelines for Black Men in the United States}},
  url          = {{http://dx.doi.org/10.1056/EVIDoa2300289}},
  doi          = {{10.1056/EVIDoa2300289}},
  volume       = {{3}},
  year         = {{2024}},
}