The issue of screening for prostate cancer is a complex one. Experts agree that screening can find prostate cancer early, but it's not clear that this is useful for everyone. That's because:
- Prostate cancer often grows very slowly. So far, doctors don't know if finding and treating it before it causes symptoms improves the chance of living longer.
- Very small prostate cancers may not cause any problems. Finding them may cause anxiety and lead to treatments that cause harmful side effects, such as bladder control problems and erectile dysfunction.
- The PSA test used to screen for prostate cancer can give incorrect results. Some men with prostate cancer have a normal PSA, which could give them a false sense of security. And some men have an elevated PSA but don't have prostate cancer. The test results could lead to fear and unneeded tests.
What are the recommended screening guidelines?
The U.S. Preventive Services Task Force (USPSTF) is the leading independent panel of experts in prevention and primary care. Its guidelines are considered the "gold standard" among doctors.
The USPSTF issued guidelines on prostate cancer screening in August 2008.
- The USPSTF does not recommend routine screening in men older than 75. In this age group, screening has not been shown to be of any benefit.
- They don't recommend either for or against screening in men younger than 75. Men this age should discuss screening with their doctor. This can help them understand their risk for prostate cancer, as well as the potential benefits and harms of early diagnosis and treatment.
Here is how some of the major medical organizations weigh in on the issue of screening.
The American Cancer Society (ACS) recommends that men work with their doctors to make an informed decision about prostate cancer screening. They should discuss the pros, cons and unknowns of screening tests. This discussion should start at age 50 for men at average risk who are expected to live at least 10 more years. Men at higher risk, such as African Americans or those with a family history of prostate cancer, should start this discussion at age 45 or even younger.
- Many expert groups, including the American College of Preventive Medicine and the American College of Physicians, stress the importance of educating men about the potential harms and benefits of screening so they can make the best decisions for themselves.
Deciding whether to have prostate cancer screening can be a tough call. Knowing all you can about your risks and prostate cancer will help make it clearer. Discuss these issues with your doctor so you can arrive at a decision that's right for you.
Also, remember that all of these recommendations are for screening purposes only for men with no symptoms of prostate cancer. They do not apply to men who have symptoms. If you have any urinary tract symptoms, talk to your doctor right away.
Created on 06/08/1999
Updated on 03/08/2010
- American Cancer Society. Prostate cancer: early detection.
- Agency for Healthcare Research and Quality. U.S. Preventive Services Task Force. Screening for prostate cancer. August 2008.
- Lin K, Lipsitz R, Miller T, Janakiraman S. Benefits and harms of prostate-specific antigen screening for prostate cancer: an evidence update for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2008;149(3):192-199.
- American Cancer Society. Detailed guide: can prostate cancer be found early?