Guys, Put Some Thought Into Prostate Cancer Screening

The prostate gland plays a specialized role in your body - it produces an ingredient of semen. Despite its small size, this organ with an under-the-radar function can play a significant role in men's health. 

"Only skin cancer affects more men in the U.S. than prostate cancer," said Eric Webb, MD, urologist at Archbold Urology. "That's why it's important for every man to discuss prostate cancer risk and prostate health with his provider."

A Rising Problem

Those conversations between men and their providers are even more important in light of recent growth in new prostate cancer cases. From 2014 to 2019, the rate of new prostate cancer diagnoses grew 3% each year, breaking a roughly two-decade street of decline, according to the American Cancer Society (ACS). Many of the new diagnoses were late-stage prostate cancer. 

What's behind the climb in new prostate cancer cases? During recent years, shifting screening guidelines may have led fewer men to have prostate-specific antigen (PSA) tests. This test measures the level of prostate-produced PSA in the blood and can help find prostate cancer before it spreads beyond the gland, making it easier to treat. 

When some screening guidelines recommended against PSA screening out of concern about detecting and overtreating too many slow-growing, nonthreatening cases of prostate cancer, many men have decided against screening. The result, according to the ACS, was more cases of cancer that went undetected until later stages. 

"Like most types of cancer, prostate cancer typically requires more invasive, complex treatment when it spreads to the lymph nodes or other organs and bones," said Josh Simmons, MD, FACP, medical oncologist and hematologist at Archbold Cancer Center. "It's tougher to eliminate advanced prostate cancer. Many men don't have symptoms early on, but a PSA test can detect cancer that isn't causing symptoms." 

Talk It Out

There's no one-size-fits-all approach to prostate cancer screening. The reasons to get screened or not vary from man to man, including age, prostate cancer risk, overall health and personal preference. The common denominator, however, is that every man should have to opportunity to discuss the issue with his provider. 

As screening guidelines aren't all in agreement, it's important to consult your provider about when and whether to test for prostate cancer. The U.S. Preventive Services Task Force (USPSTF) recommends men aged 55 to 69 discuss PSA testing with their providers. The group does not recommend PSA testing for men 70 and older. 

Like the USPSTF, the ACS recommends discussing prostate cancer screening with a healthcare provider, but on an earlier timeline. Men with the highest level of risk - those whose father and brother(s) had prostate cancer before turning 65 - should discuss screening at age 40. African American men with a father or brother who had prostate cancer before 65 are also at high risk but can wait until age 45 to talk about screening. Men at average risk of prostate cancer who are likely to live another decade or more can have the screening conversation at 50. 

"Prostate cancer screening isn't right for everyone, and like most types of medical care, it carries risks," Dr. Simmons said. "These include the possibility of false-positive or false-negative results or unnecessary, potentially harmful procedures and/or treatments. On the other hand, screening may help us find and treat potentially aggressive prostate cancer early. That's why it's worth discussing with your provider whether prostate cancer screening makes sense for you."

A variety of treatments are available for prostate cancer. Some of the most common include surgical removal of the prostate and radiation therapy. Not all men need extensive treatment. In many cases, waiting to see if the cancer progresses or causes symptoms before making treatment decisions is the most appropriate course. 

Risk Raisers

Around 13% of men in the U.S. will develop prostate cancer, according to the Centers for Disease Control and Prevention. What factors increase your risk? 

"The major risk factors for prostate cancer are out of your hands," Dr. Webb said. "One of these is aging. The risk of prostate cancer rises with age, and the majority of cases occur after 65." 

Other key risk factors include being African American or having a close relative, such as a father or brother, who had prostate cancer. Taking time to learn about your family health history is important because it can empower you to make informed decisions about your own health. 

Need a provider who can help you decide about prostate cancer screening? Find one by visiting archbold.org/providers.