Men’s Health: African-American Men at Higher Risk of False Positives in Prostate Cancer Testing

While an elevated prostate-specific antigen (PSA) test can be frightening news for men…..

……new research shows that sometimes the levels are caused by a naturally occurring hormone, and may not indicate a need for a biopsy.

Elevated levels of PSA have traditionally been seen as a potential sign of prostate cancer….

……leading to the widespread use of PSA testing, followed by biopsies of those with high PSA levels.

But, researchers at Wake Forest University School of Medicine and the University of Wisconsin School of Medicine and Public Health……

……have discovered that some elevated prostate-specific antigen (PSA) levels in men are caused by parathyroid hormone, a substance the body produces to regulate calcium in the blood.

The finding is especially significant for black men, said study co-author Halcyon G. Skinner, PhD, MPH, assistant professor of population health sciences at the University of Wisconsin.

About 20 percent of black men have elevated parathyroid hormone levels, compared with about 10 percent of white men – which means blacks have twice the risk of being recommended for unneeded biopsy and treatment, he said.

"Once they have a positive screen test, it can set off a chain of tests and treatment," Skinner said. "This finding could help spare men who are actually at low risk from invasive and unnecessary procedures."

The hormone can elevate prostate-specific antigen (PSA) levels in healthy men who do not have prostate cancer.

"PSA picks up any prostate activity, not just cancer," said lead investigator Gary Schwartz…..

……an associate professor of cancer biology and epidemiology and prevention at the Wake Forest University School of Medicine.

"Inflammation and other factors can elevate PSA levels. If the levels are elevated, the man is usually sent for a biopsy."

"The problem is that, as men age, they often develop microscopic cancers in the prostate that are clinically insignificant".

If it weren't for the biopsy, these clinically insignificant cancers, which would never develop into fatal prostate cancer, would never be seen."

However, because PSA screening has become so common, more men are being biopsied, Skinner said.

Most men, when told that they have prostate cancer, elect treatment even though it may not be necessary.

In reality, in only one of six cases does a biopsy diagnosis of prostate cancer result in a cancer that would be fatal if untreated.

Thus, high rates of prostate biopsy lead to unnecessary treatment, which can have side effects such as impotence and urinary incontinence.

Skinner said that one way to make PSA tests more accurate would be to take parathyroid hormone into account when evaluating the test.

"PSA tests were developed to check for a recurrence of prostate cancer after treatment, but they've since come to be used for diagnosis," Skinner says.

"Since it is unlikely the tests will be abandoned, adding a parathyroid panel could be a way to make the test better and to prevent unnecessary treatment."

The study appears in the current issue of Cancer Epidemiology, Biomarkers & Prevention.

For the study, the researchers analyzed data from 1,273 men who participated in the National Health and Nutrition Examination Survey 2005-2006……

……..and who did not report any current infection or inflammation of the prostate gland, prostate biopsy in the past month, or history of prostate cancer at the time of the survey.

After adjusting for age, race and obesity – because PSA levels increase with age, are higher in black men, and are lower in overweight men…..

…… the researchers found that the higher the level of parathyroid hormone in the blood, the higher the PSA level.

In men whose parathyroid level was at the high end of normal, the PSA level was increased by 43 percent ….

…..putting many in the range for the urologist to recommend a biopsy. The study was funded by grants from the National Institutes of Health and the American Cancer Society.

Article taken word for word from an article found on School of Medicine and Public Health, Univ. of Madison Wisc.

Other Good Reads on this subject:

Elevated PSA levels not necessarily a predictor for Prostate Biopsy

Scientific Paper: Racial Differences in Parathyroid Gland Hormone Dynamics

My Top 10 Prostate Health Superfoods (Part 1)

My Top 10 Prostate Health Superfoods (Part 2)

Black Sesame Seeds Fight Prostate Cancer

Culinary Argan Oil Fights Prostate Cancer

Lycopene Unleashed (The Prostate Friendly Antioxidant)

The Gac Fruit, The Prostate's Best Friend

The Prostate Cancer Fighting "Fantastic Four" !!! Broccoli, Green Tea, Turmeric, and Pomegranate

It's Time to take control of your Prostate Health

The Importance of Gamma Tocopherol (Vitamin E) in Prostate Health

New Studies Reveal the importance of Zinc in Prostate Health

Prostate Cancer Risks Greatly Reduced by increasing Omega-3 vs. Omega-6 ratios in food

Why I'm Taking "A Knee" against the Medical Industry (The Kolin Kaepernick) Article

~stay healthy~


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2 Responses


As one of the “one in six who’s biopsy was positive for cancer, I think the article is a little cavalier in its suggestion about PSA, biopsies and prostate cancer. The question men should ask (among the many) is whether they wish to take that chance of being that one in six and not getting treatment. Without any treatment, the life expectance is 5 to 7 years with the last two being very painful. So what questions should I ask to help make a reasoned decision? The article is correct in that many things, including a blow to the abdomen, stomach infections, high stress plus the hormone mentioned, can cause the elevated PSA. What the article does not say that the PSA level is not as important as the change in the PSA. Mine went from one to 3.4 in twelve months. In Australia, where I am from, 3.4 is at the upper end of the normal range. We waited a month and tested the PSA again (3.6) waited a month and tested it once more (3.7). A specialist urologist came next who performed the digital examination (I avoided these in the past in favour of the PSA). Given no evidence of abnormality from that he said “five years ago I would have patted you on the shoulder and sent you home saying do not worry. Now, I recommend a biopsy”. I had the biopsy. If you are 75 or over and you have microscopic cancer then you should let it be. If you are under 60, the cancer seems to grow and spread rapidly. If you are younger than 50, prostate cancer moves very rapidly. So things are not as simply as articles in popular magazines lead us to believe. What effects potency is whether the delicate nerves around the prostrate can be spared in surgery? If they can be spared you have a pretty-good chance, if not there is no chance (outside of a pump-up that the wife of a friend seems to be overjoyed with). That means catching the cancer early. Continence is in the skill of the surgeon and your diligence in doing pelvic floor exercises – all men should do them anyway if you do not want incontinence later in life. It also means catching the cancer early. The takeaway is – why risk not having the tests when the downsides are highest. Caveats – I am not a medical practitioner or anything else in the health related industries. I am an academic researcher and I have done a lot of research for my own knowledge. I had prostate cancer, I had robotic surgery, the cancer came back a year later; and then I had radiation treatment and all has been OK for 6 years (I am now 65). Continence is good; potency is OK with chemical assistance. If you disagree with my comments, do not bother emailing me but of course reply to the blog to inform other. If you want, ask me questions I will do my best to answer them with what I know. I found very little help available even on the web and in my circle of 8 acquaintances with prostate cancer, none would talk much about incontinence or potency.


Hi Ray McNamara,

Thanks for taking the time to comment. Sorry to hear about your health issue

The comments seems to be in opposition to my perspective on all this, but that’s OK. I think it is meant for me to get men talking about this issue, looking at it from sides, and making your best informed choice. 

I’m in no way shape or for attempting to come at this as the guru, or all knowing, all seeing expert on this subject. I watched my mother die from cancer last year, at at the end, she was a skin and bones skeleton from all the chemo treatments that in my opinion killed her. I’m pretty passionate about the whole cancer subject, the medical industry, and all related subjects.

So far you as calling my article “cavalier”, I can accept that opinion, I suppose if I truly had an issue with that comment, I would never post the comment, because I have to approve any comment before it goes live. But on the contrary, I’m not sure if you are African American or not, but I am in no ways cavalier about this subject as pertains to African American Males. I do think my perspective breaks rank with the traditional mindset of how to look at disease and so forth, but every man has to make his own call. But when you get deep into issue with African American Biochemistry as pertains to not only PSA testing, but Western Medicine in general, there is a whole Pandora’s Box that is opened there, and I think needs to be opened, because I think PSA testing, vitamin D testing, and many other types of testing and medicine are not compatible with African Biochemistry. Then there is the whole Money Driven Medicine profit motive, but that’s a whole other story

Anyway, I’ve written over a dozen posts on prostate health (most of which I linked to in this post), and I supposed they only have real value and worth if opposing and/or different points of view can be allowed to come in and present an alternate point of view, or perhaps another look at the same subject from another angle.

I suppose this could be called a “Cavalier” comment also, but to me it is intensely serious, in that cancer and other diseased is best addressed preventative, via proper nutrition, and in my opinion, that is a whole higher level understand of how nutrition works in the body. I think when PSA levels are elevated, biopsies and surgery needed, these things are the result of how we manage our bodies and health via nutrition and the wellness activities. Of course even in this case, one could argue that cancers can happen from environmental issues that we have no control over, but even environmental issues (like toxins in water) can be successfully addressed to head a happy healthy life. Of course, I’m acknowledging this paragraph is perspective an opinion. But, in my opinion, the battle against cancer has to be fought and won before the cancer even exists

I’ll finish with this quote is from the German born Dr. Albert Schweitzer:

“On my arrival in Gabon ( Africa ) in 1913, I was astonished to encounter no cases of cancer. I saw none among the natives two hundred miles from the coast…I cannot, of course, say positively that there was no cancer at all, but, like other frontier doctors, I can only say that, if any cases existed, they must have been quite rare. This absence of cancer seemed to be due to the difference in nutrition of the natives compared to the Europeans…”

…I’m of the firm belief that once African Americans get back to ancient knowledge and wisdom of native African nutrients and natural medicine (one example being the cancer fighting nutrient about B17 found in the staple African food Cassava, and the powerful almost unknown in the USA, African Superfood Baobab), this Prostate Cancer epidemic can be eradicated. Even if that is overly-optimistic, any African American male can win his own individual game with the right esoteric knowledge of his bio-chemistry, and nature’s abundant foods to nourish it.

I’m going to continue to tirelessly present information that I think is valuable for the average person trying to take control of their health and wellness, but part of that endeavor must also allow varying and different opinions, which I think is helpful for someone to make informed choices….

Doug at Gaia Health Blog


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