The
American Cancer Society (ACS) recommends that men have a chance to make an
informed decision with their health care provider about whether to be screened
for prostate cancer.
The decision should be made after getting information about the uncertainties,
risks, and potential benefits of prostate cancer screening.
Men should not be screened unless they have received this information. The
discussion about screening should take place at:
If, after this discussion, a man is unable to decide if testing is right for
him, the screening decision can be made by the health care provider, who should
take into account the man’s general health preferences and values.
If no prostate cancer is found as a result of screening, the time between
future screenings depends on the results of the PSA blood test:
Because prostate cancer often grows slowly, men without symptoms of prostate
cancer who do not have a 10-year life expectancy should not be offered testing
since they are not likely to benefit.
·
Age 50 for men who are at average
risk of prostate cancer and are expected to live at least 10 more years.
·
Age 45 for men at high risk of
developing prostate cancer. This includes African Americans and men who have a
first-degree relative (father, brother, or son) diagnosed with prostate cancer
at an early age (younger than age 65).
·
Age 40 for men at even higher
risk (those with more than one first-degree relative who had prostate cancer at
an early age).
1) After this discussion, men who want to be screened
should be tested with the
prostate-Specific Antigen (PSA) blood test. The Digital Rectal Exam (DRE) may also be done as a part of screening.
2) Men who choose to be tested who have a PSA of less
than 2.5 ng/mL may only need to be retested every 2 years.
3) Screening should be done yearly for men whose PSA
level is 2.5 ng/mL or higher.
Overall
health status, and not age alone, is important when making decisions about
screening.
Even
after a decision about testing has been made, the discussion about the pros and
cons of testing should be repeated as new information about the benefits and
risks of testing becomes available.
Further
discussions are also needed to take into account changes in a man’s health,
values, and preferences.
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