Black men may be at an increased risk of overdiagnosis for prostate cancer due to higher natural levels of prostate-specific antigen (PSA), a study by the University of Exeter suggests. The research, published in BMC Medicine, analyzed patient records of 730,000 men, revealing that PSA levels vary by ethnicity, with black men having higher levels than white men, and Asian men having the lowest. This discrepancy could lead to more black men undergoing unnecessary diagnostic testing, including prostate MRI and biopsy.
The study, funded by the National Institute for Health and Care Research, Cancer Research UK, and the Higgins Family, found that while over 80% of men had normal PSA levels regardless of ethnicity, black men were more likely to be diagnosed with prostate cancer following a raised PSA result compared to white and Asian men. However, the incidence of advanced prostate cancer was similar between black and white men, indicating that higher PSA levels in black men might not correspond to more aggressive disease.
Dr. Tanimola Martins, Senior Research Fellow and Lecturer at the University of Exeter, emphasized the historical underrepresentation of black, Asian, and other ethnic minority groups in cancer research, which may not fully reflect their experiences. The study’s findings underscore the need for more precise and accurate prostate cancer diagnosis to avoid overdiagnosis and its associated harms.
Naser Turabi, Director of Evidence and Implementation at Cancer Research UK, pointed out that the PSA test is not suitable for men without symptoms of prostate cancer and that more research is needed to develop an effective and accurate test. The study included 649,445 white men, 37,827 black men, and 31,053 Asian men, with consistent results showing the lowest PSA levels, cancer diagnoses, and rates of advanced prostate cancer in Asian men.
The research used data from general practices in England contributing to the Clinical Practice Research Datalink and was linked to the National Cancer Registration and Analysis Service. The study, titled “Association between patient ethnicity and prostate cancer diagnosis following a Prostate Specific Antigen test: a cohort study of 730,000 men in primary care in the UK,” highlights the importance of considering ethnicity in prostate cancer diagnosis and the need for further research to ensure equitable care for all men.
“Common prostate cancer test may leave black men at increased risk of overdiagnosis” (February 29, 2024)
