Newswise — In its newest recommendations, the United States Preventive Services Task Force is encouraging men ages 55 to 69 to speak with their physicians to make an individualized decision about prostate cancer screening based on their personal health, family history of the disease and risk factors such as race and ethnicity. In addition, the task force recommends against screening men age 70 years and older who may not see a benefit to screening.

Why the change? The task force determined that for males who have not been previously diagnosed with prostate cancer and who exhibit no signs or symptoms of the disease, the potential benefits and harms of prostate-specific antigen (PSA)-based screening are closely balanced in men ages 55 to 69. In men age 70 years and older, the potential benefits of PSA-based screening do not necessarily outweigh the harms.

The PSA test measures the amount of prostate-specific antigen, a type of protein, in a man’s blood. An elevated PSA may be caused by prostate cancer, but it may also be caused by an enlarged prostate or an inflammation of the prostate. PSA-based screening and prostate biopsies do not identify whether a cancer is aggressive or likely to spread. This is in part why the task force recommends that men speak with their physicians to help make health care decisions.

Christopher Kane, MD, chair of the Department of Urology at UC San Diego Health, is an internationally recognized prostate cancer specialist and researcher. Kane and other urologic oncologists at Moores Cancer Center at UC San Diego Health are available to discuss the recommendations and what they mean for men.

“Five years ago, the task force discouraged men of all ages from a PSA test because of concerns about the limited value of screening and potential overtreatment when cancer was detected,” said Kane. “Today, there is increased evidence that screening well-selected patients saves lives. Also, there is more acceptance in the medical community for avoiding over-detection and overtreatment of low-aggressive cancers through more selective testing and the more widespread use of active surveillance,” said Kane.

“This new recommendation is more in line with other health care organizations that recommend shared decision making and a thoughtful decision for men to undergo screening, particularly men from 55 to 69 years of age who are at higher risk due to family history or ethnicity. Hopefully, additional tests will help differentiate which men might most benefit from screening.”

After skin cancer, prostate cancer is the most common cancer in American men. According to the American Cancer Society, in 2017, an estimated 161,360 new cases of prostate cancer will be diagnosed and an estimated 26,730 people will die of this disease. Prostate cancer develops mainly in older men. About six out of 10 cases are diagnosed in men 65 or older. It is rare in men younger than 40.

 

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