New Prostate Cancer Screening Guidelines: What You Need to Know
Recently, the U.S. Preventive Services Task Force updated its guidelines for prostate cancer screening. Prostate cancer is the number one cancer diagnosed in men, and has the second highest rate of mortality – so staying up to date on the latest recommendations is important for your health.
Craig Rogers, M.D., a urologist at Henry Ford Health System, provides insight on the new recommendations and highlights what you need to know about the screening process.
What are the changes in screening guidelines?
“The biggest change to note is that previously, prostate cancer screening was considered a class D recommendation, meaning it was discouraged — which was difficult to come to terms with since prostate cancer is the number one cancer in men,” he says. “Now, it’s considered a class C recommendation, meaning we should discuss it with our patients to determine if screening is right for them.”
Not all men are candidates for prostate cancer screening. Men age 55-70 are most likely to benefit from prostate specific antigen (PSA) screening. However, testing may be offered selectively for younger men or healthy older men at increased risk, such as men with a family history of prostate cancer.
Debunking the controversy behind prostate cancer screenings
Interestingly, despite the prevalence of prostate cancer, screening for it has been controversial due to the high rate of false-positive test results and over-diagnosis.
“False-positive results were happening because, while the PSA blood test is specific to the prostate, it’s not specific to prostate cancer. So, things like a recent urinary tract infection or an enlarged prostate can elevate the level of PSA in the blood and artificially signal a warning for prostate cancer,” Dr. Rogers says.
If raised PSA levels are detected, patients may choose to undergo a prostate biopsy to confirm whether prostate cancer is present. Dr. Rogers notes that this can also present issues.
“Prostate cancer is often a slow growing, slow spreading cancer that doesn’t present symptoms or illness until its late stages,” he says. “It could be the case that even if a man is diagnosed, he could outlive any issues the cancer might cause.”
In the past, most cases of prostate cancer were treated in a similar way, using surgery or radiation to treat the entire prostate – even in cases of lower risk prostate cancer that might not progress to cause health issues.
With the new recommendations comes the focus that each patient is different. While one patient may need to undergo treatment to eliminate the cancer, another may just need routine observation to ensure the cancer hasn’t grown.
“Prostate cancer screening and treatment isn’t one-size-fits-all, as it was previously,” Dr. Rogers says. “Each patient’s condition is unique to them, and we want to tailor our treatments accordingly and identify those patients who are most likely to benefit from treatment and those patients who don’t need treatment and can be safely followed.”
To also help combat false-positive results and over-diagnosis, there are a variety of other tests that can be done to determine a patient’s risk level. Minimally-invasive treatment options can also help patients avoid some of the negative side effects that accompany treatment. And, through the innovation of precision medicine, patients who do require treatment can have their program specifically tailored to their cancer and tumor type.
The importance of prostate cancer screening
Despite its slow growth rate, it’s still crucial to talk to your doctor and ask him or her about when you should be screened for prostate cancer.
“While prostate cancer is usually slow growing and slow spreading, it can be deadly and remains one of the leading killers of men. If prostate cancer progresses to the point of causing symptoms, we may have lost a window of opportunity to cure the cancer,” Dr. Rogers says. “Screening is important to catch the cancer early enough to have treatment options and a high success rate.”
Learn more about prostate cancer screening and treatment at Henry Ford.
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Dr. Craig Rogers is a urologist who sees patients at Henry Ford Hospital in Detroit and Henry Ford West Bloomfield Hospital.