Martin Luther King, Jr.'s son Dexter Scott King's Death from Prostate Cancer and the Absence of Universal Prostate Cancer Screening in the U.S.
by Nayvin Gordon
January 29, 2024
Black men in the U.S. have the highest rate of prostate cancer in the industrialized world. It is a leading cause of death for all men.
“After the widespread adoption of prostate-specific antigen (PSA) screening in the early 1990s, prostate cancer diagnoses increased rapidly while death rates halved over the course of the next quarter century.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491201/
With this incredible drop in cancer death rates, one might ask why anyone would discourage early cancer screening.
Studies published by the US Preventive Service Task Force (USPSTF) and others discouraged universal PSA screening and thus it fell out of favor over the last decades.
The number of prostate cancers diagnosed each year declined sharply from 2007 to 2014, coinciding with fewer men being screened because of changes in screening recommendations. Since 2014, however, the incidence rate has increased by 3% per year overall and by about 5% per year for advanced-stage prostate cancer. (Advanced or metastatic cancer is incurable, terminal)
https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html
A report in the respected New England Journal of Medicine in 2020 reported that the studies used to discourage prostate cancer screening by the USPSTF and other organizations were problematic and that the benefit of PSA screening …“is qualitatively similar to recommendations supporting breast cancer screening,”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491201/
The death rate for prostate cancer fell by 50% in twenty-five years! Why would this achievement be discouraged?
That is why we published the article below on 8/5/19
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US Medicine’s Message to Black Men: We Won’t Spend a Dime to Find Your Cancer!
Black men in the US have the highest rate of prostate cancer in the world, twice the rate of White men. It is a leading cause of death for all men and Black men die from this cancer at over twice the rate of White men. The cancer in Blacks often spreads more quickly if not aggressively treated. https://jamanetwork.com/journals/jama/issue/320/23.
Over the last forty years, at least 30,000 Black men have died yearly from prostate cancer. Screening with the Prostate Specific Antigen (PSA) blood test can find this cancer early.
The 2018 US Preventative Services Task Force (USPSTF) report stated: “Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men.” “More aggressive screening strategies particularly those that use a lower PSA threshold …., provide the greatest potential reduction in death from prostate cancer.” https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/pros tate-cancer-screening1
While acknowledging that PSA screening saves lives the USPSTF does NOT call for universal screening of Black men for prostate cancer. The National Cancer Institute, 4/10/19, The American Cancer Society 3/11/16, and the American College of Physicians, 4/9/13, none of these organizations call for universal prostate cancer screening for Black men.
Why?
They screen women for breast cancer, why not men for prostate cancer? Screening mammography for breast cancer has been universal for decades despite knowing that the test misses many cancers. More than 40,000 women still die yearly from breast cancer.
Black men do NOT get universal prostate screening because of priorities and money.
The PSA test is “a hugely expensive public health disaster”. “As Congress searches for ways to cut costs in our health care system, a significant savings could come from changing the way the antigen is used to screen for prostate cancer.” https://www.nytimes.com/2010/03/10/opinion/10Ablin.html
“…universal counseling which may impose significant opportunity costs by diverting time from higher priority preventative services.” http://www.afpdigital.org/afp/july_15_2019/MobilePagedArticle.action?articleId=1505887#articleId1505887
“Controlling health care costs is the only way to ensure appropriate investment in other areas…” https://jamanetwork.com/journals/jama/issue/321/8
Black men are not a priority. The political priorities are obvious: Trillions of dollars in tax cuts for corporations and the rich, and trillions in dollars for the military–war machine.
Clearly, Black lives don’t matter, but it seems that White lives don’t matter much either.
8/5/19
Dr. Nayvin Gordon
Gordon writes about politics and health, and his articles have appeared in: The Mercury News, Counterpunch, Z Magazine, Countercurrents, Scoop Independent News, Anderson Valley Advertiser, Socialist Viewpoint, Multiracial Unity Blog, Scientific American, The Oakland Tribune, The Journal of Family Practice, American Family Physician and Dissident Voice. He may be reached at gordonnayvin@yahoo.com