Men between the ages of (55-69) who are candidates for prostate-specific (PSA)-based screening should discuss the pros and cons of the test with their doctors and make a personal decision about whether to take it, says Dr. Jing Zeng of Seattle Cancer Care Alliance’s Proton Therapy Center.
“There is probably a small benefit to screening for PSA levels; many men would prefer to know if they have prostate cancer, even if it is slow growing and they would remain asymptomatic for the rest of their lives. It’s a personal decision,” said Zeng, a radiation oncologist.
Zeng’s statement follows the latest US Preventive Services Task Force’s (USPSTF) update to its prostate cancer screening guidelines, which has garnered national headlines on what it means for men.
In 2012, the task force published guidelines saying the test was not worth the false positives, unnecessary biopsies and increased fear levels. That changed in 2017. The upshot now: Men are encouraged to speak with their doctor about whether it makes sense, given family history, overall health and personal risk profile to have the test done.
The problem centered on if men received a high score result that they would typically receive a biopsy. But In 70 percent of the cases, no cancer was detected; in others, only a slow growing cancer that wouldn’t impact mortality if left untreated. The evidence showed that over 14 years, PSA screening prevented between 0-1 prostate cancer deaths per 1,000 men screened.
After the 2012 guidelines were released, screening rates went down and so did diagnoses of prostate cancer, according to a report in JAMA.
When faced with a prostate cancer diagnosis, the first instinct may be to get the cancer out as quickly as possible. It’s recommended to learn about treatment options and the pros and cons of each therapy.
Fast facts on prostate cancer:
- Prostate cancer affects the prostate, a walnut-sized male sex gland located just below the bladder, and occurs most often in men older than 55.
- The majority of prostate cancers that are detected by screening tend to be small and grow slowly. Chances of surviving most early-stage, low-grade prostate cancers are excellent.
- Prostate cancer treatment is controversial. Many men with small cancers will not benefit from treatment because the cancer grows so slowly that it will not cause problems. But it isn't yet possible to determine which prostate cancers will grow rapidly, making treatment decisions difficult.
- Prostate cancer ranks as the most common form of cancer among men in the United States and is second only to lung cancer in the number of annual cancer deaths among U.S. men.
Patti Brooke of SCCA’s Proton Therapy Center contributed to this report.
