Prostate Cancer Screening

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Prostate Cancer Screening

Topic Overview

Screening for prostate cancer—checking for signs of the disease when there are no symptoms—is done with the digital rectal exam and the prostate-specific antigen (PSA) test. In the United States, about 17 out of 100 men will get prostate cancer. Out of these 17 men, 3 will die of prostate cancer. This means that 97 out of 100 men will die from something other than prostate cancer.2

The number of deaths caused by prostate cancer has dropped over the past 20 years. The decrease has been linked to more cases of early diagnosis through PSA testing and to better cancer treatment. But it is not yet known if PSA testing actually saves lives or if the benefits of having PSA screening are worth the harms of follow-up tests and cancer treatments.

Finding prostate cancer early leads you to some big decisions. Most prostate cancer grows slowly. And the side effects of treatment can change your quality of life—mainly not being able to have an erection (impotence) and not being able to control urination (incontinence). If you are older with other serious health problems, these side effects may seem worse than early-stage cancer that may not grow much during your lifetime. But for active or younger men, treatment may help them live longer.

So before you decide to have a PSA test, talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of testing. Some men will not want to live with the side effects of treatment. Other men are more concerned about survival. It is important to learn all you can and talk to your doctor before making a decision.

Click here to view a Decision Point. Prostate Cancer Screening: Should I Have a PSA Test?

After reviewing research on routine screening for prostate cancer using the PSA test, the U.S. Preventive Services Task Force (USPSTF) recommends the following:1

  • Men age 75 and older should not be screened for prostate cancer.
  • Men younger than 75 should talk with a doctor about the pros and cons of PSA testing before being tested. Men younger than 75 with long-term medical problems or who are expected to live less than 10 years are unlikely to benefit from screening.

For more information, see the topic Prostate Cancer.

References

Citations

  1. Lin K, et al. (2008). Benefits and harms of prostate-specific antigen screening for prostate cancer: An evidence update for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 149(3): 192-199.
  2. Zelefsky MJ, et al. (2008). Cancer of the prostate. In VT DeVita Jr et al., eds., Devita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 8th ed., vol. 1, pp. 1392–1452. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer J. Curtis Nickel, MD, FRCSC - Urology
Last Revised June 21, 2010

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