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Prostate Cancer Screening

It seems clear-cut: If there is a simple screening test that can help find cancer early, you should have it. But when it comes to prostate cancer, the answer just isn’t that clear, which may be surprising for many to hear.

While prostate cancer screening is popular in the United States, when all the evidence is boiled down, the benefits of screening don’t clearly outweigh the risks, like they do for some other cancers.

Tests for Prostate Cancer

The two screening tests currently available for prostate cancer are the digital rectal exam and the PSA test. With digital rectal exams, a doctor or nurse inserts a lubricated, gloved finger into the rectum to feel the prostate for anything that seems unusual. With PSA tests, a blood sample is taken to measure the amount of prostate-specific antigen (PSA) in the blood. PSA is a protein that is produced by prostate cells. Sometimes, PSA levels are higher in men with prostate cancer.

Like all cancer screening tests, one purpose of the digital rectal exam and PSA test is to find cancer in its early stages. And while prostate screening does seem to do this, it’s not clear if these tests really fill the other key part of a screening test – saving lives.

For men with aggressive prostate cancer, finding and treating the disease early may, in fact, help them live longer. But for most men with the disease, it may not matter whether prostate cancer is found early, late or not at all because it won’t become life-threatening or even cause health problems if not treated.

Treatment Side Effects

Complicating things even more, the treatment itself for prostate cancer can cause health problems or lower quality of life. Men treated for prostate cancer often report problems with leaking urine and remaining sexual active, for example.

In the face of a fatal disease, these types of things can seem less important. However, for a disease like prostate cancer that’s often not fatal even if untreated, such things can have a great impact on quality of life throughout the years.

A Personal Decision

Although prostate cancer screening remains very popular, many health organizations do not recommend regular testing for adult men. Instead, organizations like the American Cancer Society (ACS) say that prostate screening should be offered annually to all men beginning at age 50; African-American men at age 45; and men at high risk as early as age 40.

Key to this recommendation, the ACS says, is a detailed talk with a physician about the risks and benefits of testing and prostate cancer treatment. This talk can help men figure out if it’s best to be screened for the disease or put off testing and consider it again sometime later.

Click on the podcast links below to hear Siteman Cancer Center physicians discuss issues related to prostate cancer screening:

New Guidelines for Prostate Cancer Screening 
Should Prostate Cancer Screening Stop at Age 75?