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Prostate Cancer Screening
Prostate cancer screening can help men at risk identify cancer early, when treatment is most effective. Men at an increased risk include:
- Men of African-American descent
- Men with a family history of prostate cancer
- Older men. The risk of getting prostate cancer increases rapidly after 50. Over half of new diagnoses of prostate cancer affect men over 70
Prostate cancer screening can also help reassure you that it's unlikely you have prostate cancer. Prostate cancer is one of the most common cancers among men in the United States with 240,890 new cases of prostate cancer diagnosed in the United States in 2011
Typical prostate cancer screening includes a PSA (prostate specific antigen) test and digital rectal examination. This has long been recommended starting at age 40-50 depending on risk factors and continuing annually in men with a 10 year life expectancy.
PSA is a protein that is specific to prostate and passively makes its away into the bloodstream and can be detected by a simple blood draw. It is an indicator of how the prostate is behaving. PSA level can be elevated for many reasons and therefore is not very specific. PSA levels can rise because of infection, inflammation, ejaculation, as we age or because of cancer. What the PSA level provides is an indicator that brings our attention to the prostate and may prompt further workup or treatment, including antibiotics and biopsy.
In 2011, the United States Preventative Services Task Force (USPSTF) issued a recommendation arguing against PSA screening in healthy men. The same task force made a controversial recommendation against screening mammogram in certain women back in 2009. The prostate cancer death rate has decreased by 33% in the last 15 years, according to the American Cancer Society (ACS). Remarkably, this reduced prostate cancer mortality rate during the "PSA era" is not even contemplated in the USPTS draft report, which instead, focused solely on the smaller comparative studies.
The American Cancer Society and the American Urologic Association (AUA) offer different conclusions and recommendations. AUA recommends screening to start at age 40, and the American Cancer Society recommends screening to be considered starting at age 40-50 depending on risk factors of men who have 10 years life expectancy.
To get or not to get a PSA testing?
Talk to your Genesis Healthcare physician about whether prostate screening is right for you.
Click here to view a prostate cancer specialist’s response to the US Preventative Task Force recommendations.