Indigenous Men Less Likely to Receive PSA Testing

Rural doctor walking into town
Indigenous men with prostate cancer are also more likely to have higher-risk disease characteristics

(HealthDay News) — Indigenous men are less likely to receive prostate-specific antigen (PSA) testing and are more likely to be diagnosed with higher-risk prostate cancer, according to a study published online in Cancer.

Alex Kiciak, MD, from the University of Alberta in Edmonton, Canada, and colleagues conducted an observational cohort study of men diagnosed with prostate cancer between June 2014 and October 2022 to examine disparities between Indigenous and non-Indigenous men. Data were examined for 1,444,947 men.

The researchers found that men in Indigenous communities were less likely than those outside of Indigenous communities to have PSA testing performed (32 vs 46 PSA tests per 100 men aged 50 to 70 within 1 year). Of the 6049 men diagnosed with prostate cancer, Indigenous men had higher-risk disease characteristics than non-Indigenous men, including a higher proportion with PSA ≥10 ng/ml (48 vs 30%), TNM stage ≥T2 (65 vs 47%), and Gleason grade group ≥2 (79 vs 64%). Indigenous men had a higher risk of developing prostate cancer metastases than non-Indigenous men over a median follow-up of 40 months (hazard ratio, 2.3).

“The findings are significant because they identify Indigenous men as a population at risk for more aggressive prostate cancer and potentially worse survival,” a coauthor said in a statement. “Key infrastructure changes, including better access to primary care physicians, may help improve prostate cancer screening and identify men at earlier, and curable, stages of the disease.”

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text