Prostate cancer is one of the most common cancers affecting men, particularly as they age. Early detection plays a critical role in improving outcomes, which is why prostate screenings are an important part of men’s health care. However, knowing when to start screenings can be a source of confusion for many men. With so much information available, it’s essential to understand the guidelines and benefits of prostate screening to make an informed decision about when to begin.
What Is Prostate Cancer Screening?
Prostate cancer screening typically involves two main tests:
- Prostate-Specific Antigen (PSA) blood test: This test measures the level of PSA, a protein produced by the prostate. Elevated levels of PSA can indicate the presence of prostate cancer, though other conditions can also cause higher PSA levels, such as benign prostatic hyperplasia (BPH) or prostatitis.
- Digital Rectal Exam (DRE): During this exam, a doctor manually checks the prostate through the rectum to feel for any abnormalities, such as lumps or hard areas, that may indicate cancer or other prostate problems.
While both tests can help detect prostate cancer early, neither is perfect. For example, an elevated PSA level does not necessarily mean a man has prostate cancer, and a DRE may not detect all types of prostate cancer. This is why screenings are often performed alongside other tests and evaluations to help doctors make a more accurate diagnosis.
General Guidelines for Prostate Screening
The American Cancer Society (ACS) and the American Urological Association (AUA) provide general guidelines for prostate cancer screening. However, the decision of when to start screening and how often to do so depends on individual risk factors. Let’s look at these guidelines:
1. Average Risk Men
For most men, the recommended age to begin prostate screening is between 50 and 55, depending on the doctor’s advice and individual risk factors.
- Ages 50–55: Men at average risk of prostate cancer—meaning they have no family history of the disease and are not of African descent—should start discussions with their healthcare provider about prostate screening around age 50. If they choose to proceed with screening, it’s typically done every two years.
- Ages 55–69: This is the age group most men will begin regular screening. If men at average risk choose to have screening, it should continue until they are 69, with some experts recommending screening every two years, while others may suggest an annual PSA test depending on personal health and family history.
2. High-Risk Men
Some men are at higher risk of developing prostate cancer due to family history or ethnicity. Men who fall into these categories should consider starting screenings earlier.
- Men with a family history: Men who have a first-degree relative (father, brother, son) diagnosed with prostate cancer at an early age should begin screening at age 40 to 45. The risk is higher if a relative was diagnosed with prostate cancer before age 65.
- African-American men: African-American men are at higher risk for developing prostate cancer and are also more likely to develop it at an earlier age. For these men, screening discussions should start around age 45, as their risk for aggressive forms of prostate cancer is higher.
- Men with certain genetic mutations: Men with mutations in genes like BRCA1 or BRCA2, which are linked to a higher risk of prostate cancer, should also begin screening around age 40, as they may be at an increased risk for aggressive prostate cancer.
3. Men Over 70, or With Other Health Conditions
For men over the age of 70, or those with other health conditions, the decision to undergo prostate screening becomes more complex.
- Age 70 and older: Screening for prostate cancer in men over 70 is generally not recommended unless the individual is in excellent health and plans to live for at least 10 more years. Prostate cancer often progresses slowly, and in many older men, the potential benefits of early detection may not outweigh the risks of treatment, such as side effects from prostate cancer treatments.
The Pros and Cons of Prostate Screening
Prostate screening can save lives by detecting cancer early when it’s most treatable. However, there are both benefits and drawbacks to consider:
Benefits:
- Early detection: Prostate cancer often grows slowly, and early detection through screening can lead to better outcomes and more effective treatments.
- Peace of mind: For men who are at high risk or concerned about prostate cancer, screening can offer peace of mind if results are normal.
- Treatment options: Early detection of prostate cancer gives men more treatment options, including non-invasive treatments or active surveillance.
Risks:
- False positives: A raised PSA level does not always indicate cancer, leading to unnecessary tests or biopsies. This can cause stress and anxiety.
- False negatives: Not all prostate cancers will be detected through PSA testing or a DRE, which means some cancers may go undiagnosed.
- Overdiagnosis and overtreatment: Some prostate cancers grow very slowly and may not affect a man’s health during his lifetime. Screening may lead to the detection of cancers that would never have caused symptoms, resulting in unnecessary treatment and side effects such as incontinence or erectile dysfunction.
Making the Decision to Begin Prostate Screening
Ultimately, the decision of when to begin prostate cancer screening is a personal one, and it’s important to have an open discussion with your doctor. During this conversation, consider your family history, ethnicity, and overall health. Your doctor will help you weigh the risks and benefits of screening based on your individual circumstances.
It’s also important to remember that prostate cancer screenings should be done regularly and should not be a one-time event. Prostate health is something that should be monitored over time, and your doctor can guide you on the appropriate frequency of screenings as you age.
State-of-the-Art Care in Manhattan and Queens
Men should begin discussions about prostate cancer screening around the age of 50, but for those at higher risk, screening may start earlier. Prostate screening can detect potential issues early, but it’s important to have a clear understanding of both the benefits and risks involved. By speaking with your provider at Modern Urologist, you can make an informed decision about when and how often to undergo prostate screenings, ensuring that you stay on top of your prostate health as you age. To schedule a consultation, call 212-991-9991 for our Manhattan or Queens office today.
