Episode 387: Prostate Cancer Screening, Early Detection, and Disparities

“[When] a lot of men think about prostate exams, they immediately think of the glove going on the hand of the physician, and they immediately clench. But really try to talk with them and discuss with them what some of the benefits are of understanding early detection. Even just having those conversations with their providers so that they understand what the risk and benefits are of having screening. And then educate patients on what a prostate-specific antigen (PSA) and digital rectal exam (DRE) actually are—how it happens, what it shows, and what the necessary benefits of those are,” ONS member Clara Beaver, DNP, RN, AOCNS^®, ACNS-BC, manager of clinical education and clinical nurse specialist at Karmanos Cancer Institute in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about prostate cancer screening, early detection, and disparities.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 31, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to prostate screening, early detection, and disparities.

Episode Notes 

• Complete this evaluation for free NCPD.
• ONS Podcast™ Episode 149: Health Disparities and Barriers in Metastatic Castration-Sensitive Prostate Cancer
• ONS Voice articles:
  • Gender-Affirming Hormones May Lower PSA and Delay Prostate Cancer Diagnosis in Transgender Women
  • Healthy Lifestyles Reduce Prostate Cancer Mortality in Patients With Genetic Risk
  • Hispanic Patients Are at Higher Risk for Aggressive Prostate Cancer but Less Likely to Get Treatment
  • Leveling State-Level Tax Policies May Increase Equality in Cancer Screening and Mortality Rates
  • Most Cancer Screening Guidelines Don’t Disclose Potential Harms
• ONS book: Understanding Genomic and Hereditary Cancer Risk: A Handbook for Oncology Nurses
• ONS course: Genomic Foundations for Precision Oncology
• Clinical Journal of Oncology Nursing article: Barriers and Solutions to Cancer Screening in Gender Minority Populations
• Oncology Nursing Forum articles:
  • Disparities in Cancer Screening in Sexual and Gender Minority Populations: A Secondary Analysis of Behavioral Risk Factor Surveillance System Data
  • Symptom Experiences Among Individuals With Prostate Cancer and Their Partners: Influence of Sociodemographic and Cancer Characteristics
• Other ONS resources:
  • Genomics and Precision Oncology Learning Library
  • ONS Biomarker Database (refine by prostate cancer)
  • American Cancer Society prostate cancer early detection, diagnosis, and staging page
• National Institutes of Health prostate cancer screening page
• U.S. Preventive Services Task Force prostate cancer screening recommendation statement

To discuss the information in this episode with other oncology nurses, visit the ONS Communities. 

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [e-mail]

Highlights From This Episode

“The recommendations are men [aged] 45 who are at high risk, including African American men and men who have a first-degree relative who has been diagnosed with prostate cancer younger than 65 should go through screening. And men aged 40 at an even higher risk, these are the men that have that one first-degree relative who has had prostate cancer before 65. Screening includes the PSA blood test and a digital exam. Those are the screening recommendations, although they are a little bit controversial.” TS 3:42

“You still see PSAs and DREs as the first line because they’re easier for primary care providers to perform. ... Those are typically covered by insurance, so they still play that role in screening. But with the advent of MRIs and biomarkers, these have really helped refine that screening process and determine treatment options for our patients. Again, those patients who may be at a bit of a higher risk could go for an MRI or have biomarkers completed. Or if they’re on that verge with their Gleason score, instead of doing a biopsy, they may send the patient for an MRI or do biomarkers for that patient. ... These updated technologies put [patients] a little bit more at ease that someone’s watching what’s going on, and they don’t have to have anything invasive done to see where they’re at with their staging.” TS 4:35

“Disparities in screening access exist based on race, socioeconomic status, gender identity, education, and geography. It’s really hard in rural areas to get primary care providers or urologists who can actually see these patients, [and] sometimes in urban areas. So socioeconomic status can affect that, but also where a person lives. African American men with lower incomes and people in rural areas face the greatest barriers to receiving screening. It’s also important to encourage anyone with a prostate to be screened and offer gender-neutral settings for patients to feel comfortable.” TS 7:50

“I think a lot of men feel like if they have no symptoms, they don’t have prostate cancer ... so a lot of patients may put off screening because they feel fine, [they] haven’t had any urinary symptoms, it doesn’t run in their family. ...With prostate cancer, there usually are not symptoms that a patient’s having—they may have some urinary issues or some pain—but it’s not very frequent that they have that. So, just making sure our patients understand that even though they’re not feeling something, it doesn’t mean there’s not something else going on there.” TS 12:53

“Prostate cancer found at an early age can be very curable, so it’s really important for men to have those conversations with their providers about the risk and benefits of screening. And anyone that we can help along the way to be able to have those conversations, I think is a great thing for oncology nurses to do.” TS 15:44