Screening for Prostate Cancer: What You Should Know

Dr. Randy Mudge, radiation oncologist, Bronson Cancer Center; physician in chief of oncology services, Bronson Healthcare

Prostate cancer is a form of cancer that develops in the male prostate. It is one of the most common forms of cancer amongst men, second only to skin cancer. 13 out of every 100 men will develop prostate cancer in their lifetimes.

Before we go further into screening, let’s step back and talk about the risk of developing prostate cancer.

• Age is a major risk factor, with 60 percent of those who are diagnosed being 65+ years old.
• Black men are at increased risk when compared to white men. Black men are more likely to be diagnosed with prostate cancer before age 50, have more advanced disease progression at the time of diagnosis, and are more likely to die of the disease.
• Those with a family history of prostate cancer are up to three times more likely to be diagnosed with prostate cancer.
• BRCA1 and BRCA2 are genes first identified to increase the risk of breast cancer in women. These genes can also be passed down to men and increase the risk of developing prostate cancer.
• Some studies indicate that being overweight is a risk factor for developing several types of cancer, including prostate cancer.

Your healthcare provider will suggest screening for prostate cancer based on your age, symptoms and risk factors. The most common way to screen for prostate cancer is a Prostate Specific Antigen (PSA) test. This is a simple blood test that is easy to conduct and relatively inexpensive. PSA is a protein produced by both normal prostate tissue and, in most cases, prostate cancer. So, when a patient has prostate cancer, they likely have an increased level of PSA which can be detected in the blood test.

The advantage of screening for prostate cancer is to detect cancer early when treatment options are likely to be more effective. In fact, evidence shows prostate cancer deaths have decreased since the adoption of PSA screening.

There are also a few disadvantages of PSA testing. The first is false positive tests. Sometimes an elevated PSA can be caused by other non-cancerous processes. A cancer diagnosis needs to be confirmed by taking a tissue sample or biopsy of the prostate. Additionally, not all prostate cancer diagnosis’ require treatment. A positive PSA test result indicating cancer can cause anxiety for patients who may not be at a stage that requires treatment.

Recommendations to screen for prostate cancer vary among different professional groups, making it difficult for men to always know the right time to start screenings.

• The United States Task Force for Screening (USPSTF) recommends screening for men between the ages of 55-69.
• The American Cancer Society (ACS) suggests men at average-risk start annual screenings at age 50. ACS also recommends black men who have a father or brother who were diagnosed earlier than age 65 start screening at age 45. And, men who carry the BRCA1 or BRCA2 gene should begin screening as early as age 40.

Given the lack of exact agreement on screening protocol, the decision to undergo screening should be an individual one. Men should discuss benefits and risks of prostate screening with their healthcare provider by their early fifties. Additionally, most experts would recommend men stop screening at age 70 or if other serious medical conditions develop that will limit their life expectancy.

The bottom line is, the choice to be screened is yours and the more information you have, the better decision you will be able to make for yourself.

Learn more about prostate cancer, common symptoms, prevention and treatment options.

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