September is Prostate Cancer Awareness Month, so now is an ideal time to examine a surprisingly nuanced topic: the current prostate cancer screening guidelines. The American Cancer Society (ACS) estimates that about 191,930 new cases of prostate cancer will be diagnosed in the US in 2020. Even though it is common cancer in men, not all men should be screened for it.

Cancer screenings are usually recommended at certain ages and intervals to increase the chance of early detection and more effective treatment. Screenings are usually beneficial.  Prostate cancer screening can be beneficial but it also carries uncertainty because test results can be inaccurate or unclear. Other potential risks include overdiagnosis and overtreatment. 

Screening Tests

There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are: 

• A blood test called a prostate-specific antigen (PSA) test. PSA is a substance your prostate makes. This test measures the level of PSA in your blood. Your PSA level may be high if you have prostate cancer and for many other reasons, such as having an enlarged prostate, a prostate infection, or taking certain medicines.
• A digital rectal examination, when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer.

As we have said before, there are potential benefits to these prostate cancer screenings. But there are also risks associated with prostate cancer screening among those who don’t actually need to be screened based on their personal health history or family health history.  Ultimately, it comes down to an individual decision for every man.

Prostate Cancer Screening Guidelines

Rather than providing official prostate cancer screening guidelines, the American Cancer Society recommends that men have a chance to make their own informed decision with their healthcare provider about whether to be screened for prostate cancer.

When to Talk To Your Doctor

While there are no specific or official prostate cancer screening guidelines, the American Cancer Society does have recommendations on when men should talk to their doctors about the possibility of getting screened. They recommend that men talk to a doctor about whether they should be screened for prostate cancer at:

• Age 50 for men who are at average risk fo prostate cancer and are expected to live at least 10 more years.
• Age 45 for men at high risk of developing prostate cancer
  • African Americans
  • Men with one first-degree relative (father or brother) diagnosed with prostate cancer at an age younger than 65.
• Age 40 for men at very high risk for prostate cancer
  • Men who have more than one first-degree relative who had prostate cancer at an early age)

Because prostate cancer often grows slowly, men without symptoms of prostate cancer who do not have a 10-year life expectancy should not be offered testing since they are not likely to benefit. Overall health status, and not age alone, is important when making decisions about screening.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in a man’s health, values, and preferences.

Getting Screened

After talking to a doctor, men who want to be screened should get the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening. 

• Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
• Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.

Contact a Urologist

Alliance Urology Specialists is home to an expert team of urologists that are committed to providing comprehensive care to adults with urologic health issues like prostate cancer. If you are experiencing the symptoms of a UTI or another urologic condition call our office at (336) 274-1114 to make an appointment.