Prostate cancer exacts a heavier toll on Black men in the United States than any other demographic, a problem traced in part to limited screening and gaps in primary care. Recent analysis published in JAMA Network Open reveals that Black men are diagnosed with prostate cancer at rates 60% to 80% higher than men of other races, and mortality rates are double. Despite this alarming risk, awareness of early detection benefits remains low among both patients and many healthcare providers.
Interviews in the new study illustrate how Black men often rely on their primary-care clinicians to guide screening decisions, yet many described being dismissed or told PSA testing was unnecessary despite elevated risk. This “paternalistic dynamic undermines shared decision-making, an approach considered the gold standard in screening discussions.” A major reason for inconsistent screening may be mixed messages from various medical organizations: while urologists recognize PSA testing as a key mortality-reducer, only a small fraction of primary-care providers support routine use. Current national guidelines are not tailored for the higher risk of Black men, fueling uncertainty and inconsistent practice.
Diagnoses in Black men tend to occur at younger ages and more advanced disease stages, underscoring the missed opportunity. Researchers found that starting screening earlier—ideally in the 40s, versus 50s—could cut prostate cancer deaths among Black men by up to 30%. To close the gap, the article calls for updated guidance that directly addresses high-risk groups and for improved, culturally sensitive communication, so all men receive timely, informed care.
See: “Emerging Challenge in Prostate Screening: Insight from Primary Care” (September 15, 2025)
