PSA screening awareness needed among high-risk groups

One-fifth of men under age 50 reported undergoing a PSA test to detect prostate cancer in the previous year, yet only one in three young African-American men reported ever having had a PSA test in the previous year, according to researchers at the Duke University Prostate Center (Durham, NC). The findings appear in the June 23 online edition of Cancer and will appear in the Sept. 15 print edition.

“Our findings for black men are discouraging,” said senior author Judd W. Moul, MD. “We’ve been encouraging black men to get screened at age 40 or 45 for more than a decade, yet only one-third of these high-risk men reported being tested.”

To assess the number of men being screened who were between the ages of 40 and 49, Dr. Moul and colleagues reviewed the 2002 Behavioral Risk Factor Surveillance System, an ongoing, state-based, random telephone survey of the U.S. population. Their study showed several socio-demographic characteristics associated with PSA screening in young men. Young African-American men were more likely than young, Caucasian, non-Hispanic men were to report having had a PSA screening in the previous year, and younger Hispanic men were more likely to undergo PSA testing than younger, Caucasian non-Hispanic men were.

Health insurance, an ongoing physician-patient relationship, increasing obesity,and high household income and education levels were also associated with having had a recent PSA test.

Dr. Moul believes the current guidelines should be changed to encourage baseline PSA risk assessment starting at age 40.

“Even a subtle increase in the PSA value at that age is a pretty powerful predictor of future prostate disease and cancer,” he said. “Right now, only one in five men are getting a PSA test, which is encouraging, but I wish the number was higher. This research suggests we can do a better job of screening men at age 40, and a better job in high-risk men. There’s a huge population of African-American men who are not getting screened, and men with a family history of prostate cancer who are under 50 are also not getting screened.”