What men should know about prostate cancer screening?

In 2012 the United States Preventive Services Task Force (USPSTF) recommended against screening for prostate cancer which saw an increase in number of deaths due to prostate cancer. In 2017 USPSTF changed their recommendation for men to consider prostate cancer screening as a preventive method for the said cancer.

Debjani Arora | Published: August 29, 2018 6:43 pm

A PSA screening for prostate cancer is advisable. © Shutterstock

According to the American Cancer Society, prostate cancer is the most common cancer found in men and is the second leading cause of cancer-related deaths among men. The risk is greater in people who are over 50 or 60 years of age. This is why a PSA test is recommended for men over the age of 50 to keep a tab on any suspicious growth in the prostate gland. PSA is the protein-specific antigen, a protein secreted by the prostate gland. The level of PSA in the blood is a good indicator to detect prostate cancer early. Usually, if PSA levels are high in the blood, it signifies an onset of prostate cancer. Studies have shown that PSA levels that range between 2.9 to 4 ng/ml indicate that the cancer is confined to the organ and have lower progression rate.

However, in 2012 the United States Preventive Services Task Force (USPSTF) recommended against screening for prostate cancer citing two large studies. One in Europe and one the U.S. that initially seemed to fail to show a benefit in prostate cancer screening. The USPSTF recommended against prostate-specific antigen (PSA)–based screening for prostate cancer citing that it does more harm than good. They also pointed out that if it is just the PSA which is a blood test, it is still fine but if it is followed with a screening test by confirmatory biopsy it can lead to complications like bleeding, infections, etc. Most of the time some cancers are low grade and slow growing which does no harm if left untouched. This is a reason it is believed that everyone may not benefit from screening.

But the study did not take into account that prostate cancers can be of two types – aggressive and the non-aggressive ones. While the slow-growing non-aggressive ones didn’t cause much but men did face the wrath of aggressive cancer. As a result, prostate cancer screening in the United States slowed down after the USPSTF recommendations the number of deaths from prostate cancer went up in the US. More men died of prostate cancer. However, doctors still prefer that a PSA should be mandatory for men after 50 years of age but how to interpret the results are what urologists and oncologist should learn to do with precision. Sometimes an elevated PSA could be due to an enlarged prostate this can give a false –positive result. This is why if the PSA test turns to be suspicious it is necessary to talk to an oncologist or a urologist before undergoing a biopsy. Sometimes it could be due to a benign tumour. This is why the USPSTF pointed out that PSA should not make men panic.

In fact, USPSTF advises that going for a PSA is a good precaution but people should be watched closely how the prostate is behaving before planning any rigorous treatment method (pills or surgery). So recently the USPSTF said that screening for PS for men over 50 should become mandatory.

Published: August 29, 2018 6:43 pm

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