Is PSA score discriminated against African American Men?

Science is impartial. Science always provides logical explanations for each phenomenon. PSA scores increase with age, but for African-American men, PSA levels tend to be a bit higher than those of Caucasian males. A famous research report analyzed the distribution of serum PSA levels in a subject group of 3764 black and whites males with and without prostate cancer. ^[1]

Values shown were obtained in blacks and whites at Walter Reed Army Medical Center and in whites from Olmsted County, Minnesota, studied at the Mayo Clinic. In each box plot, the lower and upper ends of the "whiskers" represent the 5th and 95th percentiles, respectively; the lower and upper ends of the boxes, the 25th and 75th percentiles; and the line inside the box, the media.

According to Dr. Morgan’s published results in “The New England Journal of Medicine,” the PSA levels in African-American men without prostate cancer increased significantly than their Caucasian counterparts. PSA level differences are even higher for senior African-American men.
 
In the past, scientists found that PSA levels were just naturally higher in African-American men; the threshold standards were adjusted to avoid creating a false-positive result for recommending biopsy.
 
With the advancement of genetic tools and analysis, scientists found no race-specific differences in PSA levels. Further research and analysis were done and discovered that men with a PSA level between 1.5 to 4.0 ng/mL, despite family members with or without a history of prostate cancer, had the same predictive value--regardless of race. In fact, researchers found that PSA levels accurately predicted the risk of prostate cancer in African-American men. ^[2]
 
So why after more than a decade later, medical facts become a medical myth? Scientific reports sometimes contradict each other due to recent discoveries or crucial molecular mechanisms that are fundamentally behind each medical phenomenon not yet revealed. The original PSA study excluded a significant number of men--162 --with abnormal digital rectal examination and PSA levels from the analysis. It’s plausible that this substantial number of men with elevated PSA level without cancer were NOT included in the study.
 
After the publication, doctors perceived the statistics in different perspectives.  Dr. Sawyer and other doctors from Veteran Affairs Medical Center expressed their opinion of this particular ethnic group that is at least 70 years old, i.e. “Black men may have higher PSA levels because of non-neoplastic conditions that increase the PSA level, or the presumably disease-free population of black men may include an undetermined number of men with undiagnosed cancers.”  ^[3]
 
By paying attention to the medical care and wealth status of each retired group, an individual might realized that social factors may be involved also. As the old saying goes, “prevention is better than a cure.”
 
If you are over 35, you should pay more attention to your diet and lifestyle. Some foods may benefit your prostate health.