Regular prostate cancer screening still not advised

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The American Cancer Society released updated prostate cancer screening recommendations yesterday that largely reiterate existing guidance—advising men to discuss the issue with their physicians and make a decision about the potential benefits of screening based on their individual medical histories and age. The new recommendations incorporate recent research into the potential benefits of the prostate-specific antigen test (PSA) to detect cancer in early stages: a large-scale study of more than 180,000 men from seven different countries. They found that, screening using PSA tests roughly ever four years did reduce deaths by 20% compared with a control group, but that for every life saved, 48 men would need to be treated. A second large-scale study that informed the new guidelines included 76,600 men who either received standard care, or had annual PSA tests and rectal exams every four years. In that study, there was little difference in cancer death rates after seven and 10 year follow-up.

According to the guidelines, men who are in good health and not at high risk for developing prostate cancer should begin discussing the potential benefits of screening with their doctors at age 50. Men who have no signs of prostate cancer and are expected to live fewer than 10 years—either due to a different illness or old age—should forgo screening, according to the recommendations, as research has shown that the risks outweigh the benefits for this particular group.

As before, however, the guidelines indicate that men at high-risk for developing prostate cancer—including African-American men or men who have an immediate family member who has been diagnosed with prostate cancer before the age of 65—should begin discussing the benefits of screening by age 45. Men at extremely high risk, including those who have multiple family members who’ve been diagnosed with the disease before age 45, should consider screening beginning at age 40.

Read more about the revised prostate cancer screening guidelines here.