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May 2019

Is Prostate Cancer Screening Right for You?

Prostate cancer is the most common cancer in men after skin cancer. About 1 in 9 men will be diagnosed with prostate cancer in their lifetime.

Male doctor talking with male patient

When it comes to screening for the disease, expert advice has evolved. In 2012, the U.S. Preventive Services Task Force (USPSTF) recommended against the prostate-specific antigen (PSA) blood test as a screening tool for prostate cancer. But now, the USPSTF suggests that PSA screening is a personal decision men between ages 55 and 69 and their doctors should make together.  

High PSA levels don’t tell the whole story

PSA is a compound that both healthy cells and cancer cells in your prostate make. Doctors can test the PSA level in your blood. Higher PSA levels increase the likelihood of having prostate cancer.

The USPSTF is a panel of experts that makes evidence-based recommendations about screenings and preventive services. The agency had previously suggested that the harms of screening could outweigh the benefits. One downside of PSA-based screening is that if it shows higher-than-normal PSA levels, you could have additional tests and even unneeded treatment for prostate cancer. It’s possible to have prostate cancer that wouldn’t cause symptoms during your lifetime if left untreated.

What the new recommendation says

The USPSTF now suggests that men ages 55 to 69 should discuss prostate cancer screening with their healthcare providers. The recommendation is based on long-term research that shows there’s a small chance PSA-based screening can reduce your risk of dying of prostate cancer. The USPSTF recommends that you talk about the pros and cons of screening with your healthcare provider so that you can make the best decision for you.  

The USPSTF doesn’t offer specific screening recommendations for men with a family history of the disease. But it suggests that men who have a close relative who was diagnosed with advanced prostate cancer, whose prostate cancer spread, or who died from prostate cancer may benefit most from prostate cancer screening.

According to the American Cancer Society and the American Urological Association, African-American men and men who have a father, brother, or son diagnosed with prostate cancer may be at higher risk and should talk to their healthcare provider about whether to be screened for prostate cancer at an earlier age.

The USPSTF continues to recommend against PSA-based screening for men ages 70 and older. Research shows PSA-based screening for these men doesn’t reduce the risk for death.

What you should do

If you’re a man ages 55 to 69, talk with your healthcare provider about prostate cancer screening. Ask what factors you should consider before deciding whether to test your PSA levels.

When it comes to your health, it’s important to have a health care provider by your side. If you don’t have a primary care provider you can talk with, call your health insurance company to find providers in your network or ask friends and family for their recommendations.

Online Medical Reviewer: Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
Date Last Reviewed: 4/1/2019
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