Update on Racial Disparities in PSA Screening and Detection

How to cite: Nyame YA. Update on Racial Disparities in PSA Screening and Detection. Grand Rounds in Urology. February 2026. Accessed Apr 2026. https://grandroundsinurology.com/update-on-racial-disparities-in-psa-screening-and-detection/

Summary

Yaw A. Nyame, MD, MS, MBA, Associate Professor, Department of Urology, University of Washington, Seattle, Washington, examines persistent racial disparities in prostate cancer incidence and mortality and discusses how screening strategies, healthcare access, and structural factors influence patterns of disease detection among Black men.

Dr. Nyame explains that prostate cancer represents the largest racial disparity of any cancer in the United States, with Black men experiencing substantially higher incidence and mortality compared with other populations. According to data, Black men have approximately 1.8 times higher prostate cancer incidence and more than twice the risk of death from the disease.

He reviews research examining the drivers of excess mortality. Studies suggest that several factors contribute to disparities in prostate cancer death rates, including increased cancer onset, delayed diagnosis leading to more metastatic disease at presentation, and differences in survival among men with localized disease.

Dr. Nyame discusses how screening practices may influence these outcomes. Analyses evaluating intensified prostate-specific antigen (PSA) screening strategies demonstrate that increased screening frequency and broader biopsy use could reduce prostate cancer mortality but may also increase detection of indolent disease. Age-restricted screening strategies may help preserve mortality benefits while limiting overdiagnosis.

Dr. Nyame examines patient and clinician perspectives on prostate cancer screening. Qualitative interviews with Black men reveal limited awareness of prostate cancer risk and screening options, as well as barriers to PSA testing within healthcare systems. Primary care physicians often serve as gatekeepers for PSA testing, and differences in clinicians’ perceptions of screening benefits may influence access to testing.

Dr. Nyame describes ongoing research initiatives to improve screening strategies for high-risk populations. These include efforts to develop updated screening guidance and to propose clinical trials evaluating screening approaches, such as PSA testing combined with magnetic resonance imaging. He emphasizes that addressing prostate cancer disparities will require both optimized screening strategies and broader efforts to improve awareness, access, and healthcare system engagement.

The International Prostate Cancer Update (IPCU), is a multi-day, CME-accredited conference focused on new developments in prostate cancer treatment, diagnosis, and prevention. IPCU 36 will feature lectures, interactive discussions, panel roundtables, debates, and case reports. This conference is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer.

The goal of this educational program is to equip healthcare professionals involved in the diagnosis and treatment of prostate cancer with the up-to-date clinical knowledge and tools they need to best treat their patients. The program will discuss the treatment of prostate cancer from diagnosis to treating advanced and metastatic disease. The conference aims to give physicians exposure to a comprehensive review of treating prostate cancer patients and to give them a chance to discuss the issues with peers and experts.