At What Age Should You Be Screened For Prostate Cancer? State & Feds Say Ask Your Doctor

Apr 11, 2017

A federal task force is walking back a 2012 recommendation that men between ages 55 and 69 not be screened for prostate cancer.

That brings federal guidelines in step with recommendations from a state task force, released last week.

Both the U.S. Preventative Services Task Force and the Pennsylvania Prostate Cancer Task Force now advise men to talk with their doctors about whether they should be screened.

UPMC Shadyside Chief of Urology Benjamin Davies sat on the state panel, and said widespread screening can lead to over-diagnosis and treatment of cancers that were never likely to become fatal.

“The problem is that that type of nuancing between types of cancer is challenging for patients and physicians to understand,” Davies said. “It’s much easier to be binary … than it is to be nuanced, but treatment in prostate cancer does need to be nuanced.”

The state report said screening “may be appropriate” for “patients who are black or have a positive family history of more than one family member with prostate cancer.”

The type of screening at issue in the federal recommendation is called prostate-specific antigen screening, or PSA. NPR’s Shots blog reports:

While PSA tests can detect prostate tumors at their smallest, most treatable stage, the testing has some risks, (Dr. Kristen Bibbins-Domingo, a professor of medicine at the University of California San Francisco) says.

The harms include stressful false alarms that often to lead to painful and sometimes dangerous biopsies. And even if the test detects an actual malignancy, many prostate cancers grow so slowly that they never become life-threatening. Nonetheless, many men undergo surgery and radiation, which can leave them incontinent or impotent.

The Pennsylvania panel recommends that patients with low-risk cancer not receive treatment and instead be monitored by their doctors.

Davies estimated that, prior to 2012, bout 50 percent of men diagnoses with prostate cancer received unnecessary treatment.