Prostate cancer diagnoses are climbing again in the U.S., and Black men are facing the steepest consequences. A recent report from the American Cancer Society shows a 3% annual increase in cases from 2014 to 2021, with the sharpest rise in advanced-stage disease. Black men are 67% more likely to be diagnosed than white men—and nearly twice as likely to die from it.
The shift follows changes in screening guidelines. In 2008 and 2012, the U.S. Preventive Services Task Force advised against routine PSA testing, aiming to reduce overdiagnosis and avoid unnecessary treatments. But researchers now say those recommendations may have contributed to the surge in late-stage cancers. “These recommendations coincided with an increase in advanced prostate cancer diagnoses,” said Tyler Kratzer, MPH.
Dr. Ahmedin Jemal emphasized that informed decision-making about screening is often missing. “The uptake in screening is low,” he said, “which may have contributed to the increase in late-stage diagnoses.” He urged men to talk to their doctors starting at age 50—or 45 for Black men and those with a family history.
While mortality rates have declined, the pace has slowed. Since 2001, deaths among Black men have dropped faster than among white men, but the racial gap remains wide. Researchers point to genetic factors, social determinants of health, and disparities in PSA testing as possible contributors.
See: “More Advanced Prostate Cancers After USPSTF Guideline Change” (September 3, 2025)
