Prostate cancer: Should you be screened?

Wednesday, May 30, 2018

Whether a man should be screened for prostate cancer is a complicated decision.

So, health officials offer this simple advice: consult your primary care doctor. That’s the latest recommendation from the U.S. Preventive Services Task Force on screening for prostate cancer – the most common cancer among men after skin cancer. Men who fall between the ages of 55 and 69 should make an individual decision about whether to have the screening, which involves a blood test.

More than 160,000 men are expected to be diagnosed this year with prostate cancer. Nearly 30,000 will likely die, according to the National Cancer Institute.

The most common tests for prostate cancer are a digital rectal exam and the PSA test, which measures the amount of prostate-specific antigen, a type of protein, in the blood. While a higher PSA level in the blood can indicate cancer, it can also be caused by many other conditions, such as an enlarged prostate or inflammation of the prostate. Ten years ago, many doctors and professional organizations encouraged yearly PSA screening at age 50. However, the practice changed after research showed many men were being treated unnecessarily. “For men who are more interested in the small potential benefit and willing to accept the potential harms, screening may be the right choice for them,” said Dr. Douglas K. Owens, a member of the task force, which is a panel of experts who make evidence-based recommendations on preventive health services. “Men who place more value on avoiding the potential harms may choose not to be screened.”

This is one reason why the task force recommends men discuss the potential benefits and harms of screening with their doctor.

The recommendation also states that men who are 70 and older should not be routinely screened for prostate cancer because the potential benefits do not outweigh the harms. The guideline applies to all adult men who have no signs or symptoms of prostate cancer and who have never been diagnosed with the disease. It also includes men at increased risk, such as those who have a family history and African-American men. “Prostate cancer is one of the most common cancers to affect men and the decision whether to be screened is complex,” said Dr. Alex H. Krist, another member of the task force. “Men should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances.” Be sure to see your doctor if you have any of the following symptoms, which may be caused by other medical conditions other than prostate cancer.
  • Difficulty starting urination.
  • Weak or interrupted flow of urine.
  • Frequent urination, especially at night.
  • Difficulty emptying the bladder completely.
  • Pain or burning during urination.
  • Blood in the urine or semen.
  • Pain in the back, hips, or pelvis that doesn’t go away.
  • Painful ejaculation