Would the below statements from the American Family Physician (11/2024) be true if, after 40 years of a prostate cancer epidemic, it was White men, not Black men who have been suffering and dying?
“Black men: Compared with White men, Black men have a more than 60% higher incidence of prostate cancer, an earlier age at diagnosis, a higher rate of metastatic cancer at the time of diagnosis, and a two to three-fold higher rate of prostate cancer mortality. Unfortunately, none of the large prostate cancer screening trials included adequate numbers of Black men to determine any specific recommendations for screening.”1See Prostate Cancer Screening: Common Questions and Answers.
Black men in the U.S. have the highest rate of prostate cancer in the industrialized world. It is a leading cause of death for all men and Black men die from this cancer at over twice the rate of White men. The cancer in Blacks often spreads more quickly if not aggressively treated.
Over the last forty years, at least 30,000 Black men have died yearly from prostate cancer. Screening with the Prostate Specific Antigen (PSA) blood test can find this cancer early.
The 2018 US Preventative Services Task Force (USPSTF) report stated: “Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men.” “More aggressive screening strategies particularly those that use a lower PSA threshold …., provide the greatest potential reduction in death from prostate cancer.”
While acknowledging that PSA screening saves lives the USPSTF does NOT call for universal screening of Black men for prostate cancer. The National Cancer Institute, 4/10/19, The American Cancer Society 3/11/16, and the American College of Physicians, 4/9/13, none of these organizations call for universal prostate cancer screening for Black men.
Why?
Black men do NOT get universal prostate screening because of priorities and money.
The PSA test is “a hugely expensive public health disaster”. “As Congress searches for ways to cut costs in our health care system, a significant savings could come from changing the way the antigen is used to screen for prostate cancer.”2See Opinion | The Great Prostate Mistake (Published 2010).
Americans waste an enormous amount of money on an inaccurate test for prostate cancer.
The political priorities are obvious: Trillions of dollars in tax cuts for corporations and the rich, and trillions in dollars for the military–war machine.
Are all lives equally worthy?
ENDNOTES: