Do African-American men need separate prostate cancer screening guidelines?

Divya Shenoy,Satyaseelan Packianathan,Srinivasan Vijayakumar,Allen M Chen

doi:10.1186/s12894-016-0137-7

Abstract

BackgroundIn 2012, the United States Preventative Services Task Force issued new guidelines recommending that male U.S. residents, irrespective of race, no longer be screened for prostate cancer. In African American men, the incidence of prostate cancer is almost 60 % higher and the mortality rate is two to three times greater than in Caucasians. The purpose of this study is to reduce African American men's prostate cancer burden by demonstrating they need separate screening guidelines.MethodsWe performed a PubMed search using the keywords: African American, Prostate cancer, Outcomes, Molecular markers, Prostate-specific Antigen velocity, PSA density, and to derive data relevant to our hypothesis.ResultsIn our literature review, we identified several aspects of prostate cancer that are different in Caucasian and African American men. These included prostate cancer incidence and outcome, the clinical course of the disease, serum PSA levels, genetic differences, and social barriers. It's also important to note that the USPSTF guidelines were based on two studies, one of which reported that only 4 % of its participants were African American. The other did not report demographic information, but used participants from seven European countries with small African American populations.ConclusionGiven the above, we conclude that separate prostate cancer screening guidelines are greatly necessary to help save the lives of African Americans.

Highlights

In 2012, the United States Preventative Services Task Force issued new guidelines recommending that male U.S residents, irrespective of race, no longer be screened for prostate cancer
The American Urological Association’s stance has alluded to the fact that due to the difference in disease course, there ought to be some differences in the approach to screening for prostate cancer; we propose that this statement understates the necessity and importance of separate screening guidelines by failing to address the differences in disease course between African Americans and Caucasians
It is important to note that currently there is no cure for metastatic prostate cancer and African American men are the most likely individuals to present with aggressive prostate cancer at initial diagnosis that advances to metastatic prostate cancer [7]

Summary

Introduction

In 2012, the United States Preventative Services Task Force issued new guidelines recommending that male U.S residents, irrespective of race, no longer be screened for prostate cancer. In African American men, the incidence of prostate cancer is almost 60 % higher and the mortality rate is two to three times greater than in Caucasians. Prostate cancer represents the most common male visceral cancer in the United States. In African-American men, the incidence of prostate cancer is almost 60 % higher and the mortality rate is two- to three-times greater than that of Caucasian men. These numbers have remained remarkably constant for more than 20 years [3]. A commonly held perception about prostate cancer in the lay public and even within the scientific community is that prostate cancer is generally an indolent disease

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