18 May 2022

New study indicates its benefits may be greatest for Black population

Prostate cancer screening using PSA blood tests is more effective than previous evidence has suggested, according to new research published in a prestigious American journal. PSA testing may be particularly effective for identifying prostate cancer in Black men, who are more likely to get, and die of, the disease than other men.

The study, published in New England Journal of Medicine Evidence, looked at how successful PSA tests were for all races by estimating how the benefit of avoided deaths balanced against the potential harms of overdiagnosis and overtreatment. The researchers looked at three decades of records to 2016, the last year records were available, to gain a long-term view.

The authors conclude that their statistical analysis shows that “longer follow-up alone indicates a more favorable harm-benefit tradeoff than suggested previously”. The tradeoffs between harms and benefits “are consistently more favorable for Black men across modeling assumptions and estimation methods”.

They say: “Given the long natural history of prostate cancer, we find substantially more favorable harm-benefit tradeoffs than what were implied a decade ago, which were largely revealed by the longer follow-up times”.

“Our findings highlight the need to account for the increased value of screening in Black men in clinical guidelines.”