For decades, the public has heard an emphatic message: early detection of cancer saves lives. This is the basis for the recommendations for cancer screening exams, including mammograms and colonoscopy. Screening recommendations for prostate cancer, however, have been a bit different. Medical experts recommended in 2012 against routine prostate cancer screening, because the risks appeared to outweigh the benefits. Many doctors stopped routine ordering of the test.
That position has now been modified in new guidelines from the U.S. Preventive Services Task Force, which recommend that primary care physicians discuss prostate cancer screening with their patients aged 55 to 69.
“The new guidelines are specifically about the protein specific antigen (PSA) test,” says Shailen S. Sehgal, M.D., a board-certified urologist at St. Clair Hospital. “They suggest that PCPs discuss risks versus benefits of PSA-based prostate cancer screening with their male patients aged 55 to 69. Physician and patient need an informed, individualized process to decide whether that patient would benefit from prostate cancer screening based on PSA testing. Some, particularly African Americans and those with a family history of prostate cancer, may need to be steered toward PSA screening, as they have a higher risk of dying from the disease.”
The PSA blood test measures a protein that can be elevated in the presence of prostate cancer. It is a non-specific test, however, that can also indicate infection, inflammation or benign prostate enlargement. Detecting an elevated PSA often leads to biopsy, and that in turn can lead to surgery or radiation, which may result in side effects, including impotence and incontinence.
A positive finding for prostate cancer, explains Dr. Sehgal, may be insignificant, as many prostate cancers grow slowly or not at all. He encourages men who are concerned to speak with their PCP or urologist to determine their individual needs.
Dr. Sehgal practices with The Center for Urologic Care. Contact him at 412.833.3000.