As a Black man in my mid-40s and a researcher in ethnic inequalities in cancer diagnosis, I read Steve McQueen’s story with both personal and professional interest (‘My father’s death saved my life’: director Steve McQueen on grief, gratitude and getting cancer, 5 April). His advocacy for early detection is powerful – but the article would benefit from important nuance regarding prostate cancer diagnosis and race/ethnicity.
Black men typically have higher baseline PSA levels – a biological variation that is rarely acknowledged and can lead to overdiagnosis if universal thresholds are applied. Moreover, UK data show that Black men are less likely to present with advanced-stage prostate cancer compared with white men.
While emotionally compelling, calls for race-targeted screening must be grounded in evidence-based policy design. Without this, we risk reinforcing, or even generating, new inequities.
Greater focus should be placed on shared decision-making that incorporates a range of factors – including age, family history, ancestry and social determinants of health – rather than putting too much emphasis on race.
Tanimola Martins
Senior research fellow, University of Exeter
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