Men’s Health: Is Prostate Cancer Screening Right For You?
Prostate cancer is the most common cancer in men after skin cancer. About one in nine men will be diagnosed with prostate cancer in his lifetime. An estimated 174,650 new cases of prostate cancer will be diagnosed in the U.S. this year, according to the American Cancer Society. The incidence of prostate cancer is about 60 percent higher in African-American men than in Caucasian men. When it comes to screening for the disease, expert recommendations have evolved. In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against the prostate-specific antigen (PSA) blood test as a screening tool for prostate cancer. But now, the USPSTF suggests that PSA screening is a personal decision for men between ages 55 and 69 and their doctors to make together.
Adeep B. Thumar, MD, Medical Director of Urology at Summit Medical Group, says, “As men age, the prostate may start causing symptoms, such as weak stream, incomplete emptying, urinary frequency, or night-time urination. Discuss possible symptoms of prostate cancer with your primary care physician or a urologist.”
HIGH PSA LEVELS DON’T TELL THE WHOLE STORY
PSA is a compound that both healthy cells and cancer cells in your prostate make. Doctors can test the PSA level in your blood. Higher PSA levels increase the likelihood of having prostate cancer.
The USPSTF, a panel of experts that makes evidence-based recommendations about screenings and preventive services, previously suggested that the harms of screening could outweigh the benefits. One downside of PSA-based screening is that if it indicates higher-than-normal PSA levels, you could undergo additional tests and even unnecessary treatment for prostate cancer. It’s possible to have prostate cancer that wouldn’t cause symptoms during your lifetime if left untreated.
WHAT THE LATEST GUIDELINES SAY
The American Urological Association (AUA) offers the following guidelines:
- Men under age 40 should not be screened.
- No routine screening between ages 40 and 54. However, there are some risk factors which may promote screening in this age range: Family history of metastatic adenocarcinoma, African American race, multiple generations of first-degree relatives with prostate cancer development at younger ages
- Men ages 55 to 69 are strongly advised to discuss the benefit of screening with their health care provider, which is consistent with USPSTF guidelines.
- Screening interval with PSA blood testing may be annually to biannually based on risk and baseline values.
The USPSTF and the AUA continue to recommend against routine PSA-based screening for men ages 70 and older. Research
shows PSA-based screening for these men doesn’t reduce the risk of death.
WHAT YOU SHOULD DO
If you’re a man ages 55 to 69, talk with your health care provider about prostate cancer screening. Ask what factors you should consider before deciding whether to test your PSA levels.
“Men with close relatives who have been diagnosed with advanced prostate cancer, or who died from prostate cancer, and possibly those with early prostate cancer, would likely benefit the most from prostate cancer screening. Discuss it with your primary care physician or urologist,” advises Dr. Thumar.