The American Cancer Society urges every man to discuss the advantages and disadvantages of prostate cancer screening with his personal physician before making the decision about whether or not to undergo testing. It is important to receive all the information available about the potential benefits, risks and uncertainties of screening for prostate cancer before making a decision. Men should receive this information first before undergoing screening. The screening discussion should occur:
- At age 50 for any man who has an expected lifespan of at least ten more years and who faces an average risk of being diagnosed with prostate cancer
- At age 45 for any man who faces a high risk of receiving a prostate cancer diagnosis, including African American males and patients who have a son, brother or father who received a prostate cancer diagnosis before reaching the age of 65
- At age 40 for any man who has more than one son or brother who was diagnosed with prostate cancer before reaching the age of 65
After discussing the situation with a physician, men who choose screening should undergo a blood test that screens for prostate-specific antigen, or PSA. Physicians may also perform a digital rectal exam, or DRE, during the screening.
If the patient cannot make a decision about whether to undergo screening, the physician may make the decision after taking into account the man’s values, preferences, and overall health condition.
If the screening does not detect prostate cancer, the physician may recommend future screenings depending on the PSA blood test results as follows:
- Screening should take place every two years in men with a PSA result up to 2.5 ng/mL.
- Screening should take place annually in men with a PSA result of 2.5 ng/mL or more.
Prostate cancer is slow growing, so men who exhibit no symptoms and are not expected to survive for ten years should forego testing because it will not be beneficial to them. When deciding whether to undergo screening, overall health should be taken into account as well as age.
As the industry produces updated information about the risks and benefits of testing, men should be informed about the advantages and disadvantages of screening even if they have already made a decision about testing. Future discussions about the pros and cons of prostate cancer screening are advised as the patient’s preferences, values and health change.