ORIGINAL ARTICLE | CLINICAL GUIDELINES DEVELOPMENT Prostate Cancer Foundation Screening Guidelines for Black Men in the United States Isla P. Garraway, M.D., Ph.D.,1 Sigrid V. Carlsson, M.D., Ph.D., M.P.H.,2,3 Yaw A. Nyame, M.D., M.S., M.B.A.,4,5 Jason L. Vassy, M.D., M.P.H., M.S.,6,7 Marina Chilov, M.L.S.,8 Mark Fleming, M.D.,9 Stanley K. Frencher Jr., M.D., M.P.H.,10 Daniel J. George, M.D.,11 Adam S. Kibel, M.D.,12 Sherita A. King, M.D.,13 Rick Kittles, Ph.D.,14 Brandon A. Mahal, M.D.,15,16 Curtis A. Pettaway, M.D.,17 Timothy Rebbeck, Ph.D.,18,19 Brent Rose, M.D.,20,21 Randy Vince, M.D.,22 Robert A. Winn, M.D.,23,24 Kosj Yamoah, M.D., Ph.D.,25,26 and William K. Oh, M.D.27,28 Published April 23, 2024 DOI: 10.1056/EVIDoa2300289 NEJM Evid 2024; 3 (5) For personal use only. No other uses without permission. Copyright © 2024 Massachusetts Medical Society. NEJM Evidence is produced by NEJM Group, a division of the Massachusetts Medical Society. Downloaded from evidence.nejm.org by WILLIAM OH on April 23, 2024. For personal use only. No other uses without permission. Copyright © 2024 Massachusetts Medical Society. All rights reserved. Question 1. Should Black men be screened for prostate cancer? • Statement 1: Yes. Since Black men are at high risk for prostate cancer, the benefits of screening generally outweigh the risks. Question 2. What should Black men know about how screening for prostate cancer is conducted? • Statement 2: Prostate-specific antigen (PSA) is a blood test that should be considered first-line for prostate cancer screening. Some providers may recommend an optional digital rectal exam (DRE) in addition to the PSA test. Question 3: What information should Black men obtain to make an informed decision about PSA screening for the early detection of prostate cancer? • Statement 3: Decisions about PSA testing depend on individual preferences. Black men should engage in shared decision-making with their health care provid- ers and consult other trusted sources of information to learn about the pros and cons of screening. Question 4: At what age should Black men obtain their first PSA test, and how often should they be screened for prostate cancer? • Statement 4: For Black men who elect screening, a baseline PSA test should be done between ages 40 and 45. Depending on the PSA value and the individ- ual’s health status, annual PSA screening should be strongly considered. Question 5. At what age should Black men consider stopping PSA screening? • Statement 5: Black men over age 70 who have been undergoing prostate cancer screening should talk with their health care provider about whether to continue PSA testing and make an informed decision based on their age, life expectancy, health status, family history, and prior PSA levels. Question 6. How should family history and genetic risk be taken into consideration when screening Black men for prostate cancer? • Statement 6: Black men with an even higher risk of prostate cancer due to a strong family history and/or known carriers of high-risk genetic variants should consider initiating annual PSA screening as early as age 40.
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