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Developing Evidence of the Risks and Benefits of PSA Screening in Black Men to Inform National Guidelines and Personalized Decision-Making

Award Number: R01CA315460
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/20/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2031

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Developing Evidence of the Risks and Benefits of PSA Screening in Black Men to Inform National Guidelines and Personalized Decision-Making - PROJECT SUMMARY/ABSTRACT Background: Prostate cancer affects American men of all backgrounds, but its burden falls unevenly. Black men face 64% higher incidence (188.7 vs. 114.9 per 100,000) and more than double the mortality (36.9 vs. 18.4 per 100,000) compared to non-Hispanic White men. Despite this elevated risk, PSA screening guidelines lack evidence-based recommendations for Black men because Black men comprised only 4.4% of participants in landmark trials (e.g., PLCO). Major guideline organizations (USPSTF, NCCN, ACS) explicitly call for research to address this critical evidence gap. Objective: Conduct comprehensive secondary analysis of Veterans Health Administration (VHA) data to determine PSA screening benefits and harms specifically in Black men, addressing the largest evidence gap in PSA screening for high-risk populations. Methods: Analyze longitudinal data from 5+ million Veterans of varied backgrounds (including 900,000+ Black men) across 130 VHA facilities, 2005-2024; the largest cohort of Black men with detailed PSA screening data ever assembled. Use triangulated methodology: (1) individual-level marginal structural models addressing time-dependent confounding, (2) facility-level analyses exploiting natural practice variation, and (3) population-level microsimulation modeling. Analysis leverages VHA's Informatics and Computing Infrastructure (VINCI), integrating the Corporate Data Warehouse (60+ data domains) with additional datasets, enabling comprehensive multi-level analysis impossible with traditional single-dataset approaches. Innovation: Pioneers marginal structural model application to PSA screening research, leverages unprecedented VINCI dataset integration, and employs multi-level triangulation maximizing analytical rigor. Advanced natural language processing automatically detects metastatic outcomes (97.9% specificity) while facility practice variation provides natural experiments for causal inference. Enhanced microsimulation incorporates real-world VHA data rather than survey-based estimates. Impact: Results will inform evidence-based race-specific PSA screening recommendations for Black men, the group at the highest risk. Team includes national guideline panel members (NCCN, ACS) positioned for rapid policy translation. The resulting framework improves screening for the highest-burden group, while advancing real-world methods applicable to all men. Expected Outcomes: Deliver race-specific estimates of PSA screening benefits and harms, enabling tailored recommendations that optimize the benefit–harm ratio for Black men. This project delivers solution-oriented research using integrated real-world data, advancing NIH priorities in real-world data science and training the next generation of physician-scientists.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $460,134 )
2026	2026	VETERANS MEDICAL RESEARCH FOUNDATION OF SAN DIEGO	3350 LA JOLLA VILLAGE DR	SAN DIEGO	CA	92161	SAN DIEGO	USA	Cancer Detection and Diagnosis Research	000	1	7/20/2026	NEW	$460,134
														Subtotal = $460,134

Grand Total All Awards = $460,134

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Developing Evidence of the Risks and Benefits of PSA Screening in Black Men to Inform National Guidelines and Personalized Decision-Making

Award Number: R01CA315460

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/20/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2031

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