Discuss prostate cancer screening with your doctor

Prostate cancer is the second leading cause of cancer-related deaths in American men. Approximately one in nine men will be diagnosed with prostate cancer during their lifetime, and nearly 30,000 men die from prostate cancer annually.

At some point in their lives, many men will undergo screening for prostate cancer. Current screening involves a rectal exam and blood test for PSA (prostate specific antigen), which is a protein produced by the prostate gland. A high or rising PSA may indicate the development of prostate cancer and would prompt further testing, such as a biopsy.

Unfortunately, PSA is not a perfect test as not all men with a high or rising PSA will have prostate cancer, and in recent years there has been much debate about the screening process. In 2012, the US Preventative Services Task Force (USPSTF) recommended against prostate cancer screening after a major study, called the PLCO trial, failed to demonstrate any benefits and highlighted potential harms of unnecessary biopsies and over treatment. However, the American Cancer Society, American Urologic Association, and National Comprehensive Cancer Network all continued to recommend screening, citing major flaws with the PLCO trial and referencing other studies where benefits were more clearly shown.

These varied conclusions caused confusion among many patients and their primary care providers about whether they should continue to offer screening. This confusion was cleared up in May of 2018, when the USPSTF updated their recommendations due to the introduction of new, stronger evidence of the potential benefits from prostate cancer screening. Rather than recommending against screening, they now agree that screening should be a shared decision between patients and their providers.

According to the American Urologic Association, prostate cancer screening is generally performed for men between the ages of 55 and 69. Men younger than 55 are usually not screened unless they have a strong family history or other risk factors. Certain men older than 70, who are in good health with a 10 to 15-year life expectancy, may also benefit from screening.

Men and their physicians should have a thorough discussion about the benefits and potential harms of screening. At Benefis, we offer comprehensive men’s healthcare from prostate cancer screening to treatment, including the latest innovations in robotic prostate surgery and radiation therapy. Have an honest conversation with your primary care doctor and contact the Benefis Health System urology specialists at 406-455-8051 for more information.