Black Men Caught in Prostate Cancer Screening Controversy

Dr. Chiledum A. Ahaghotu, M.D.

By Dr. Chiledum A. Ahaghotu, M.D Prostate cancer is the leading type of cancer in men in the United States, with over 240,000 men diagnosed and 30,000 thousand dying from it each year. Also, for reasons that are not completely understood, African-American men have the highest rates of prostate cancer in the U.S, as 1 in 5 will get prostate cancer in their lifetime. African-Americans are also 60 percent more likely to be diagnosed with prostate cancer and 2.5 times likely to die of the disease. When caught early, prostate cancer can be treated, usually successfully. But because many men experience no symptoms, it is often identified only by an abnormal result on a basic prostate cancer screening called the PSA test. The PSA test is a blood test that measures prostate-specific antigen (PSA), a protein produced by the prostate gland. An increase in the PSA level is often the only sign of early prostate cancer. The PSA test is also valuable in monitoring patients after treatment. In May 2012, despite tremendous opposition from prostate cancer experts, legislators, healthcare advocates and cancer survivors across the country, a US Preventative Services Task Force (USPSTF) Committee announced a recommendation that PSA testing should no longer be performed routinely. The task force came to this decision based on studies in the U.S. and Europe suggesting that prostate cancer screening does not appear to improve survival in patients with this disease. One of the major concerns raised by opponents of the recommendation is that the studies lacked representation by African-American participants. The USPSTF committee also failed to acknowledge the impact of screening on declining cancer death rates. Opponents of this recommendation felt that the bottom line is that fewer men are dying of prostate cancer, and it is very likely that early detection has played a role in this outcome. Despite the decrease in death rates, African-American men continue to carry a disproportionately higher death rate and, among men under the age of 60, are 4 times more likely to have metastatic disease at diagnosis. There is currently ongoing research to find better screening strategies than the PSA test. However, until these tests have been confirmed, the PSA test continues to be important part of early detection. Any man that is over 40 years of age should have meaningful dialogue with his healthcare provider to understand the details of the PSA test, its value, and possible shortcomings. Prostate cancer screenings are not provided under the Affordable Care Act, so make sure you choose a health insurance policy that covers PSA screenings. However, Medicare provides regular prostate cancer screenings. Prostate Cancer Awareness Week is Sept. 16-22, and free prostate health assessments will be offered at over 500 locations across the country. To find a location, visit www.prostateconditions.org/screening-site. Or call 303-313-4685/Toll free: 1-866-4-PROST-8. Learn more about prostate cancer at www.prostatehealthguide.com. Chiledum A. Ahaghotu, M.D., F.A.C.S. is Chief of Urology at Howard University Hospital and Adviser to Men’s Health Network.
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