If you or those close to you were diagnosed with prostate cancer, you are not alone. Prostate cancer cases are rising and expected to double globally by 2040 compared to 2020 levels. According to The Lancet, global cases may increase from 1.4 million in 2020 to nearly 3 million by 2040. In the United States, prostate cancer cases could double by 2060, highlighted Dr. Keith Crawford, PHEN’s Director of Clinical Trials and Patient Education, at the 2024 Prostate Cancer Disparity Summit.
In the US, cases have already surged by 71% from 2019 to 2024. Black men, in particular, face a significantly higher risk of prostate cancer compared to White men. This group of men is 73% more likely to be diagnosed and 120% more likely to die from the disease compared to White men. However, early detection can improve outcomes, with 10-year survival rates exceeding 95% for early-stage cases. With various screening guidelines available, how do you know which to follow?
Understanding Prostate Cancer Screening Guidelines
Four major organizations offer prostate cancer screening guidelines, including:
- The American Cancer Society (ACS)
- The American Urological Association (AUA)
- The National Comprehensive Cancer Network (NCCN)
- The United States Preventive Services Task Force (USPSTF)
While all four organizations provide guidance, only the ACS, AUA, and NCCN offer specific recommendations for Black men who face greater risk. Fortunately, the guidelines from these three organizations are generally similar.
Key Screening Recommendations for Black Men and High-Risk Groups
- AUA and NCCN: Recommend African American men and other high-risk individuals (e.g. those with genetic mutations or a family history of prostate cancer) begin screening at age 40.
- ACS: Suggests African American men start screening at age 45, or at age 40 for those with multiple first-degree relatives affected by prostate cancer.
- Screening Frequency: The ACS and AUA recommend screening every two years while the NCCN suggests annual PSA testing.
- When to Stop: All three organizations advise discontinuing screening at age 70 or when life expectancy is less than 10 years.
PHEN’s Screening Recommendations: Follow NCCN Guidelines
At PHEN, we recommend that African American men and other high-risk individuals start PSA testing at age 40, which is in alignment with NCCN guidelines. We also support annual PSA testing for those at increased risk.
In addition to PSA tests, we encourage a more comprehensive screening approach that incorporates genetic testing and multi-parametric MRI (mpMRI). These additional tools can help identify aggressive cancers early, allowing for timely intervention when necessary.
Active Surveillance in Low-Risk Cases
For men with slow-growing prostate cancer, active surveillance – a strategy of close monitoring without immediate treatment – may be beneficial. This approach includes regular PSA tests, digital rectal exams, and potentially biopsies, allowing doctors to monitor the cancer closely while avoiding unnecessary treatments and their side effects. Immediate intervention will only be considered if the cancer shows signs of progression.
Addressing Prostate Cancer Disparities
Increasing awareness and access to early detection screening is crucial for saving lives and reducing the African American prostate cancer disparity. Recent trends show a concerning rise in prostate cancer diagnoses, particularly at advanced stages, which has slowed the decline in prostate cancer mortality. This year, approximately 299,010 new cases and 35,250 deaths from prostate cancer are expected in the US alone.
By following PHEN’s recommendation to start PSA testing at age 40, Black men can reduce their risk of late-stage diagnosis and improve their long-term chances of survival. We recommend continuing screening every one to two years, depending on PSA results.
Take Action: Early Detection Saves Lives
Early detection can save lives, especially for Black men and other high-risk groups who face higher rates of prostate cancer. Talk to your doctor about starting PSA testing and visit PHENPSA.com for more information about prostate cancer screening guidelines.
