Background: PSA screening has become standard practice in the US although mortality data from controlled trials is lacking to assess the efficacy of screening of African American men. We investigated whether PSA screening efficacy is similar among elderly Caucasian and African American men.

Methods: This case-control study compared PSA exposure history of Surveillance, Epidemiology, and End Results (SEER) dataset-derived cases deceased from prostate cancer to that of control subjects from a linked Medicare dataset. The prostate cancer cases include males diagnosed with prostate cancer between 1992 and 2005 that subsequently died from the disease (matched with 3:1 on race, age, and SEER region).

Results: We identified 8,846 cases deceased from prostate cancer, and 23,538 age-, race-, and SEER site-matched controls. African Americans comprised about 10% of both the cases (779) and controls (2,337). Conditional logistic regression analyses were used to calculate prostate cancer-specific mortality among African American (1.09 [95% CI 0.917–1.303]) and Caucasian subjects (1.14 [95% CI 1.076–1.201]) who were asymptomatic at the time of their PSA screening test.

Conclusions: The results of this large, claims-based, case-control study suggest that the efficacy of PSA screening among elderly African American men is not dissimilar to that of elderly Caucasian men, and that neither group benefitted from reduced mortality attributable to screening.

Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):PL04-02.