To Screen or Not to Screen For Prostate Cancer-That Is the Question.

Helping to answer the questions of screeing for prostate cancer

Prostate cancer is one of the most common cancers to affect men and is the second most common cause of cancer death in men following lung cancer.  There are over 30,000 deaths in the U.S. each year from prostate cancer.

Screening for prostate cancer has been controversial for the past few years.  A U.S. Task Force recommended against screening all men for prostate cancer.  This task force felt that there were too many false positive tests, too many prostate biopsies and too many men receiving treatment such as radiation therapy and surgery which result in complications such as erectile dysfunction\impotence and urinary incontinence.

Now that same Task Force released new recommendations that men aged 55-69 consider screening after a discussion with their doctor about the risks and benefits associated with screening and then the men and their doctors should decide on the best course of action regarding proceeding with a screening PSA test.

It is true that screening offers a small potential benefit of reducing the chance of dying of prostate cancer.

The same Task Force recommends against screening for men 75 years of age and older.  As many of these men will have slow-growing prostate cancer and will not likely succumb to the cancer but likely will die of some other cause.

My advice for men with a family history of prostate cancer, that is a man with close relative such as father, brother, or uncle with prostate cancer strongly consider having a PSA blood test as there is an increased likelihood of prostate cancer and an increased risk of dying from prostate cancer in men with relatives who have the disease.  The same advice also applies to African-American men who also have an increased risk of developing prostate cancer.

Bottom Line:  Not every man needs to be screened for prostate cancer.  However, every man should have a discussion with their doctor and review the benefits vs. the risks of screening and then make the screening decision.

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