Investigating the risk of harm to Black men in prostate cancer diagnosis (360G-Wellcome-314362_Z_24_Z)

Despite its limitations, the prostate-specific-antigen (PSA) test enables the detection of prostate pathologies, including cancer. PSA values are naturally higher among UK Black men than among men of other ethnicities, a factor not currently considered in clinical guidelines. Although Black men have a higher incidence of prostate cancer, they are less likely to have advanced-stage disease and often report treatment regret. This project aims to determine if Black men in the UK are over-investigated, over-diagnosed, or over-treated for prostate cancer due to their higher PSA values, and whether ethnicity-specific thresholds could reduce these negative outcomes. The project will analyse multi-source linked electronic-health-records of men who underwent PSA testing in England. It will examine PSA testing patterns and associated clinical outcomes by ethnicity and model the impact of ethnicity-specific PSA thresholds on prostate cancer outcomes. The outputs may prompt policy reconsideration regarding the primary care use of PSA tests and set the agenda for further research on establishing ethnicity-specific PSA thresholds. The University of Exeter offers a supportive environment for mid-career researchers like me, and the project steering group comprises recognised experts in the field. If successful, this award will help me advance to the next phase of my academic career.