From the Guidelines
Hispanic men should begin annual PSA screening at age 45, as they are considered to be at a higher risk of developing prostate cancer compared to non-Hispanic white men, but not as high as African American men. This recommendation is based on the most recent evidence from the American Cancer Society guidelines, which suggest that men at higher risk, including African American men and men with a family member diagnosed with prostate cancer before age 65, should receive information about prostate cancer screening beginning at age 45 1. The PSA test measures the level of prostate-specific antigen in the blood, with levels above 4.0 ng/mL typically warranting further evaluation. When beginning screening, men should discuss with their healthcare provider both the benefits of early detection and the potential drawbacks of screening, including false positives that may lead to unnecessary procedures.
Some key points to consider when starting annual PSA screening in Hispanic men include:
- The screening process involves a simple blood test that can be performed during a routine physical examination
- Regular screening is important because prostate cancer often produces no symptoms in its early stages when treatment is most effective
- Men with additional risk factors, such as a family history of prostate cancer, may need to begin screening even earlier than age 45
- The American Cancer Society guidelines recommend that asymptomatic men who have less than a 10-year life expectancy based on age and health status should not be offered prostate cancer screening 1.
It's worth noting that the evidence on prostate cancer screening in Hispanic men is not as extensive as it is for other populations, and more research is needed to fully understand the benefits and risks of screening in this group. However, based on the available evidence, starting annual PSA screening at age 45 appears to be a reasonable approach for Hispanic men.
From the Research
Age to Start Annual PSA Screening in Hispanic Men
- There is no strong consensus on the age at which to start PSA screening, as stated in the study 2.
- Most guidelines recommend PSA screening to start no later than at age 55 and involve well-informed men in good health and a life expectancy of at least 10-15 years, according to 2.
- Some suggest starting screening in early midlife for men with familial predisposition and men of African-American descent, as mentioned in 2.
- However, there is limited information available on the specific age to start annual PSA screening in Hispanic men.
- The US Preventive Services Task Force recommends against PSA-based screening for prostate cancer in men 70 years and older, as stated in 3.
- A study on non-Hispanic Black and non-Hispanic White US veterans found that PSA screening was associated with reduced risk of prostate cancer-specific mortality among both groups, but annual screening was associated with reduced risk only among Black men, according to 4.
- Other studies have compared the efficacy of digital rectal examination and serum prostate-specific antigen in the early detection of prostate cancer, but do not provide specific guidance on the age to start screening in Hispanic men, as seen in 5 and 6.
Considerations for PSA Screening in Hispanic Men
- Hispanic men may have different risk factors and health outcomes compared to other populations, which should be taken into account when considering PSA screening.
- The decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician, as recommended in 3.
- Clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs, according to 3.