Association between prediagnostic PSA level and prostate cancer probability in Black and non-Hispanic White men

Although Black men are more likely than non-Hispanic White men to develop and die from prostate cancer, limited data exist to guide PSA screening protocols in Black men. A study among 75,295 Black and 207,658 White male veterans evaluated the association between prediagnostic PSA level and probability of prostate cancer. At any given PSA level, Black men were more likely to harbor prostate cancer (OR 1.50; p<0.001). At a PSA level of 4.0 ng/ml, the probability of prostate cancer for a Black man was 49% compared with 39% for a White man. Black veterans with a PSA of 4.0 ng/ml had an equivalent risk of prostate cancer as White veterans with a PSA of 13.4 ng/ml.