Recommendations Changing Slightly For Prostate Cancer Screening

PITTSBURGH (KDKA) – There are new recommendations regarding screening for prostate cancer.

A few years ago, experts said the test was doing men more harm than good and advised doctors to not do it.

Now, that is changing ever so slightly.

Men ages 55 to 69 could have PSA testing. This is an updated recommendation from the United States Preventative Services Task Force – an independent panel of national experts in prevention and evidence-based medicine.

Five years ago, the panel’s recommendation had been not to offer PSA screening. A re-evaluation of the evidence is behind the update.

“It basically leaves it to the discretion of the primary care doctor, or the urologist, of any individual who wants to consider PSA-based prostate cancer screening, to them and the patient that they see,” St. Clair Hospital Urologist Dr. Shailen Sehgal said.

A PSA is prostate specific antigen. It a protein that circulates in a man’s bloodstream. If it’s high, it could be because of cancer, or other things such as prostate enlargement or inflammation.

Once you have a high PSA, whether it’s from cancer or not, it leads to biopsies to find out for sure. And positive biopsies lead to treatment, which can have side effects.

Other tests are in research to specifically improve cancer detection. For example, tests to check the urine, or how fast the PSA level is rising, or the ratio of the blood level to prostate size.

“I do think you’ll see a change with primary care doctors. I think they’ll be more inclined to have a rational conversation with their patients that are 55 to 69 about the risks and benefits of prostate cancer screening that’s PSA based,” Dr. Sehgal said.

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Certain demographic groups, namely men with a family history of prostate cancer, and African-American men, are at a higher risk of having and dying of the disease. So, it makes sense for those in the 55 to 69 age group to make informed, individualized decisions about testing.

The task force does not recommend PSA testing for men 70 and older, as the risks outweigh the benefits in this group.

More from Dr. Maria Simbra

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