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Prostate Cancer Screening Guidelines for Black Men
Sponsoring Organization: Prostate Cancer Foundation
Background and Objective
Black men have both an extremely high incidence of prostate cancer and a significantly higher lifetime risk of dying from it compared with other groups. Current screening guidelines typically include recommendations regarding Black men, but the recommendations are somewhat variable.
A multidisciplinary panel conducted a comprehensive evidence-based systematic review and selected 264 studies deemed relevant for addressing 6 key questions regarding screening of Black men in the U.S.
Key Recommendations
- Black men should be screened for prostate cancer as the benefits generally outweigh the risks.
- Prostate-specific antigen (PSA) testing is considered the front-line screening method; some clinicians may opt to add a digital rectal exam.
- Shared decision making with providers is key for individuals to make informed decisions about whether to undergo screening.
- Screening should begin with a baseline PSA test between ages 40 and 45. Depending on health status, yearly PSA testing should be considered.
- Individuals who have a family history of prostate cancer or high-risk genetic variants should consider starting screening at age 40.
- After age 70, individuals should discuss with their provider whether to stop screening.
Comment
A recent increase in the incidence of men presenting with advanced prostate cancer has been attributed by some to the change in prostate cancer screening guidelines a decade ago, recommending against universal screening. The Prostate Cancer Foundation's stand-alone guideline for Black men provides evidence-based recommendations to lessen the burden of disease in this high-risk population.
Citation(s)
Author:
Garraway IP et al.
Title:
Prostate Cancer Foundation screening guidelines for Black men in the United States.
Source:
NEJM Evid
2024
May
; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Robert Dreicer, MD, MS, MACP, FASCO