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New Recommendations for Prostate Cancer Screening

Cancer care is constantly evolving. Changes in diagnosis and treatment are regularly developed. They’re based on ongoing studies and reviews of new evidence gathered by cancer professionals around the world.

Now a change has been made in when men should be screened for prostate cancer. The screening recommendations come from the U.S. Preventive Services Task Force. This organization is an independent, volunteer panel of experts in prevention and evidence-based medicine.

The Recommendations

The Task Force recently posted a draft recommendation statement about screening for prostate cancer. The updated recommendations apply to men of different ages:

  • Men age 55 to 69 — Visit with your health care professional. Together you can make an individualized decision about if and when you should have prostate cancer screenings.
  • Men age 70 and older — Should not be screened for prostate cancer.

What is the prostate gland? 

The prostate gland is an organ located just below the bladder and is only present in men. The only function of the prostate is to produce semen.  The urine channel (urethra) runs through the middle of the prostate.

What is prostate cancer?

Cancer of the prostate occurs very commonly in men with over 220,000 new cases in the United States every year. About 30,000 men in the United States die of prostate cancer every year. Many prostate cancers are slow-growing and do not cause harm, but some forms of prostate cancer can be aggressive and cause death.

What is prostate cancer screening? 

Prostate cancer screening is a process by which doctors or other qualified clinicians test for signs of prostate cancer in men who have no symptoms of the disease.  Testing typically involves a blood test called a PSA (prostate specific antigen) level and possibly a rectal exam to feel the prostate gland. 

What is PSA?

PSA is a protein produced by the prostate gland. PSA levels usually go up with prostate cancer but can also go up for other reasons. These include:

  • Benign (non-cancerous) prostate enlargement
  • Inflammation or infection, also called prostatitis
  • Instrumentation/trauma: Having a catheter placed or riding a bicycle long distances
  • Ejaculation (orgasm) 

Who should be screened for prostate cancer? 

Men can consider being screened for prostate cancer typically starting at about the age of 55 and going up to about the age of 69. Men who are African-American or have a brother or father with a history of prostate cancer could consider screening earlier than age 55.  Men who are in excellent health could consider screening beyond the age of 69.  Diagnosis at an early stage results in much better survival than when the cancer has already spread.  

Why should I be screened for prostate cancer?

The benefit of screening is that cancer may be detected in its early stages. When prostate cancer is caught at an early stage, it is more easily treated and can often be cured. There are certainly some prostate cancers that are low risk and may never require treatment.

What are the risks of prostate cancer screening?

There is a risk of having a PSA elevation which is a false positive. This means that your PSA is elevated for reasons not related to prostate cancer. There is also a risk of having to undergo prostate biopsy which could be negative for cancer.  There are small risks of prostate biopsy such as discomfort during the procedure, bleeding, or infection.  There is also a risk of being diagnosed with a low risk prostate cancer which may not require treatment but could lead to anxiety or stress.

What if my PSA is elevated?

If your PSA is elevated and your prostate feels normal on exam, the next step would typically be a repeat PSA level to confirm the results. Prior to a repeat PSA test, it is recommended that ejaculation or bicycle riding be avoided for about 72 hours.  If your PSA  is confirmed as being elevated, the urologist might recommend  a prostate biopsy.

How do I decide if I should be screened for prostate cancer?

Review this information and discuss any questions you may have with your physician or qualified clinician.

How often should a man be screened for prostate cancer? 

Screening should be considered every 1-2 years.  Guidelines for screening vary.  Depending on the results of your test and your other risk factors such as family history you are encouraged to discuss prostate cancer screening with your Primary Care provider.

If you have questions about these symptoms, see your health care professional. Together you can develop a course of action that works best for you.

The American Cancer Society has practical steps you can take to reduce your cancer risks.

Anytime you have a significant diagnosis, such as cancer, getting a second opinion can give you peace of mind. A second opinion can help ensure you know and understand all your treatment options.

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Meet the Author

Peter F. Leonovicz, MD, is a urologist located at Milwaukee, New Berlin and Franklin, WI. He has advanced training and has been very involved in the development and expansion of the urologic robotic program at Aurora St. Luke’s Medical Center.

Read more posts from this author

The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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