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Prostate cancer does not always produce symptoms, so the most common way to catch prostate cancer is by scheduling regular exams and screenings. Men of average risk should be offered the option for prostate cancer screening beginning at age 50. If you are higher risk, please talk to your doctor about being screened earlier.
Prostate Cancer Screening and Recommendations
Prostate-specific antigen (PSA) tests also may be performed as a screening test for prostate cancer. A PSA is a blood test that looks for a protein produced by the prostate; elevated levels may indicate the presence of cancer, but can also be due to an enlarged or inflamed prostate gland without cancer.
PSA screening offers earlier diagnosis and higher cure rates for prostate cancer. Spectrum Health has adopted new guidelines for screening men for the possibility of prostate cancer.
These new guidelines are in response to an uptick in the number of prostate cancer patients who are being diagnosed in advanced stages, rather than early on in the disease. Decisions about whether to screen and when to begin screening for prostate cancer should be based on shared decision-making between you and your providers. The evidence is substantial that delaying these screenings carries real risk to patients.
In 2012, the United States Preventative Services Task Force suggested limiting prostate cancer screenings, concerned about the number of false positive tests and questionable benefit to patients. However, an increasing number of late stage prostate cancer patients over the past five years have altered that recommendation. Recent evidence suggests a greater than 3% annual increase in the number of patients with metastatic cancer after the initial USPSTF recommendation against PSA screening.
Spectrum Health adopted the new prostate cancer screening guidelines in October 2017. These guidelines align with those of the National Comprehensive Cancer Network, the American Cancer Society, the American Urological Association and even the United States Preventative Services Task Force.
The new prostate screening guidelines:
- Men of average risk should be offered the option for prostate cancer screening beginning at age 50.
- Prostate-specific antigen (PSA) with a digital rectal exam (DRE) is the recommended method for prostate cancer screening. DRE alone is not considered sufficient screening for prostate cancer.
- Screening should not be offered or continued in men with a life expectancy of less than 10 years.
- Frequency of subsequent PSA testing after the initial test should be based on the value (every 4 years if PSA <1, every 2 years for PSA between 1 and 3, and every year if PSA >3).
In most cases, men should continue PSA screening until the age of 70 and then stop.
The bottom line is that men should discuss their options for screening with their primary care provider.
"Each patient needs to make their own decision about whether to be screened," said Dr. Lane. "Our revised guidelines encourage men to talk about prostate screening with their physician and act on the decision that is made."
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