NCPA - National Center for Policy Analysis

Little Racial Gap in Prostate Cancer Screening

January 16, 2004

The gap in severity of prostate cancer at time of diagnosis between white and African-American men has narrowed sharply since the advent of guidelines calling for black men to begin screening for the cancer at a younger age, a new study concludes.

Because prostate cancer is diagnosed in black Americans at twice the rate of whites, and blacks are twice as likely to die of it, the American Cancer Society in 1997 recommended that black men begin screening for prostate cancer at age 45, rather than 50, the guideline for the male population at large.

A study which followed 1,968 white men and 364 African American men for the period prior to the new guidelines (1990 to 1996), and the time period following (1997 to 2001) found that:

  • Between 1990 and 1996, the average initial level of prostate specific antigens (PSA) -- a blood marker that indicates how advanced the disease is at time of diagnosis -- was15.8 for black patients and 8.4 for white patients.
  • Between 1997 and 2001, the average PSA level at time of diagnosis was 9.8 for black patients and 8.4 for whites.
  • African American men were 2.5 to 3.1 years younger than white men at the time of diagnosis.

While the results do not prove a link between the change in guidelines and the narrowing of the gap, experts believe that the results suggest the guidelines are being followed and there is increased PSA screening in the African American population.

Source: "Prostate Cancer: A Racial Divide," New York Times, December 23, 2003; based on Charlie Pan et al., "The Association Between Presentation PSA and Race in Two Sequential Time Periods in Prostate Cancer Patients Seen at a University Hospital and its Community Affiliates," December 1, 2003, Vol. 57, No. 5, International Journal of Radiation Oncology, Biology, Physics, American Society for Therapeutic Radiology and Oncology.

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