Black men need prostate cancer consultation at age 40, expert says

February 10, 2014 | by

Prostate cancer screening – which test is best, how often to test – is a complex issue for all men and the medical community as a whole.

prostate gland

African-American men are 60 percent more likely than white men to develop prostate cancer and 2.4 times more likely to die of the disease.

In fact, black men are 60 percent more likely than white men to be diagnosed with prostate cancer compared to other racial and ethnic groups. Furthermore, they are twice as likely to die of the disease, and more prone to having tumors that grow rapidly and spread to other parts of the body.

With Black History Month calling attention to lingering health disparities faced by African-American men in the United States, prostate cancer diagnoses and deaths stand out. For African-American men, the issue can be especially difficult as the disease disproportionately affects them.

“This is an aspect of health African-American men have to be alert to because it’s a big, big problem,” said Cy Stein, M.D., Ph.D., Arthur & Rosalie Kaplan Chair in Medical Oncology. “African-American men tend to get diagnosed late, and they tend to have more aggressive cancers than those found in other racial and ethnic groups.”

Stein’s advice: All black men should have a consultation with a urologist starting at the age of 40.

“There should be some consideration given to having a PSA test,” Stein said. “It doesn’t mean you have to get one – and if you do, it doesn’t mean that you have to act on it. But it’s still valuable to some, especially those with a family history – particularly in the immediate family, such as a father or brother with prostate cancer.”

Prostate-specific antigen, or PSA, testing has been a complicated consideration for men in recent years. The test measures the blood level of a protein produced by the prostate gland. The higher the level, the higher the likelihood a man has prostate cancer. However, there are other reasons for elevated PSA levels – and some men with prostate cancer do not have elevated PSA. The test was once widely used for screening, but after some studies found the tests didn't reduce deaths from prostate cancer, some advisory groups began recommending against them.

Stein said it’s important for African-American men in particular to see a physician to discuss their specific risk factors for prostate cancer, the potential benefits and harms of screening, and to determine the best course of action to protect their health.

Stein says that Jamaica appears to be the “epicenter” of prostate cancer – for reasons that are completely unclear. While those of West Indian descent seem particularly susceptible, the problem is a serious one for all blacks.

“We’re all composed of genes from all kinds of people from all over the world,” Stein said. “Why is it in this segment of the population that it’s a worse problem? The answer is, nobody knows.”