Investigators have uncovered misconceptions and gaps in awareness regarding prostate cancer and screening guidelines in light of Prostate Cancer Awareness Month in September, according to a recent survey conducted by The Harris Poll.
Background
In 2024, an estimated 299,010 men will be diagnosed with prostate cancer and 35,250 men will die from the disease in the United States, according to the American Cancer Society (ACS). The incidence of prostate cancer is about 70% higher in Black men compared with White men. However, nearly 67% of men aged 55 to 69 years report that they are not being screened for prostate cancer. As a result, the rate of advanced stage prostate cancer diagnoses has increased after decades of decline.
The ACS currently recommends that men begin discussions with their health-care providers about prostate cancer screening as early as age 40, depending on their risk level. Prostate cancer screening is designed to catch the disease in its earliest stages, prior to the development of signs or symptoms. Among men who want to be screened, the initial step typically involves a prostate-specific antigen (PSA) blood test, resulting in a PSA score. All men considering undergoing screening should have a life expectancy of at least 10 more years.
The organization recommends that discussions about prostate cancer screening take place at age 50 in men who are at average risk of prostate cancer, age 45 in men at high risk of developing prostate cancer—including Black men and men who have a first-degree relative who received a prostate cancer diagnosis prior to age 65—and age 40 in men at the highest risk of disease, including those with more than one first-degree relative who had prostate cancer at an early age.
Survey Methods and Findings
In the recent survey, the investigators asked 1,197 U.S. men aged 45 and older to answer questions about their current state of knowledge about prostate cancer and screening guidelines. The online survey was conducted on behalf of the American Cancer Society from August 15 to 19 and 20 to 22, 2024. The sampling precision of the survey was measured using a Bayesian credible interval. For this study, the total sample data is accurate to within + 3.3 percentage points using a 95% confidence level.
The investigators discovered that 60% of men mistakenly believed that the first step to prostate cancer screening was a rectal examination performed by a health-care provider. Hispanic men were more likely to mistakenly believe this compared with White men (69% vs 58%, respectively).
Among the men who had not communicated with a health-care provider about undergoing screening for prostate cancer, 49% of them were more likely to speak with their providers if they knew the first step was a blood test. The investigators noted that among the men who had not been screened for prostate cancer, 37% of them stated that they didn’t think they needed to be screened for prostate cancer yet—which was the most common reason. An equal proportion of Hispanic and Black men (25%) were unsure or mistakenly believed they didn’t need to be screened for prostate cancer unless they experienced potential signs and symptoms of the disease, and 56% of the men involved in the survey didn’t know that erectile dysfunction could be a sign of prostate cancer.
Additionally, 38% of the participants didn’t know that a family history of prostate cancer influences eligibility for prostate cancer screening. For instance, 72% of Black men acknowledged the impact of family history compared with 56% of Hispanic men and 61% of White men.
Conclusions
To educate men on the importance of prostate screening, the ACS plans to launch the Know Your Score campaign in partnership with Alonzo Mourning, a National Basketball Association player and a prostate cancer survivor. Through this campaign, the ACS will aim to encourage men to have proactive conversations with their health-care providers. By learning their PSA scores and working closely with their physicians, men who are diagnosed with prostate cancer can then make informed decisions about treatment.
“What’s most concerning is that while prostate cancer is highly survivable, it’s still the second leading cause of cancer death in men. This is because once prostate cancer advances and spreads beyond the prostate, it becomes much more difficult to treat, and survival rates significantly decrease,” emphasized Karen E. Knudsen, MBA, PhD, Chief Executive Officer of the ACS and ACS Cancer Action Network. “This survey shows that there is still a gap in understanding prostate cancer screening recommendations, which suggests discussions with health-care providers are not taking place. By educating men on the importance of early detection and prevention strategies, for those who choose to undergo regular screening, we have the ability to save lives and reverse the increase in late-stage prostate cancer diagnoses,” she concluded.
