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Should Race and Ethnicity Be Factored into Prostate Cancer Screening Guidelines?

We examined racial and ethnic differences in PSA screening and prostate cancer diagnoses between 2009 and 2014. PSA screening rates differed considerably by race and ethnicity. Among men ages 50–64, PSA screening rates decreased 18 percent (from 40.5 percent to 33.3 percent) among white men, while remaining relatively unchanged among black men (from 42.2 percent to 41.9 percent). 

The incidence of prostate cancer diagnoses declined dramatically among all men between 2009 and 2014. Black men ages 65 and older had the highest incidence of prostate cancer in each of the six years studied.

Clinical guidelines for PSA screening require a more nuanced consideration of race and ethnicity rather than blanket recommendations for all racial groups or high-risk classifications based on race alone. In addition, the clinical data and study participants upon which recommendations are based should be transparent.