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Prostate Cancer Screenings: Should You be Tested?

Prostate-specific antigen, or PSA, is currently recommended for men between the ages of 40 and 75, and used to detect early signs of prostate cancer. Typically, PSA tests are performed during an annual doctor’s visit. But, in a recent recommendation issued by the United States Preventative Services Task Force (USPSTF), these screening guidelines and their effectiveness are being called into question.

Although the recommendation is just that—a recommendation, it has left many men wondering what to do about PSA testing and whether or not they’re off the hook during the next visit to the doctor. But Dr. David McGinnis, a urologist at Bryn Mawr Hospital, Main Line Health, says not to jump to conclusions quite yet.

“The USPSTF’s proposal downplays the benefits of these screenings,” he explains. “Although overtreatment is a concern, we also don’t want to run the risk of not detecting something in time to treat it, either.”

Since regular PSA tests were introduced in the 1980s, the number of deaths from prostate cancer has decreased by more than 40 percent, due largely to the fact that these tests have allowed doctors to improve their efforts in early detection. PSA tests alone cannot detect cancer, but an abnormal test result prompts doctors to conduct a biopsy.

So what makes the USPSTF want to re-think screenings? PSA tests have some drawbacks, as well. Although PSA testing detects life-threatening cancers in the prostate, it can detect some harmless ones, too.

Some of the cancers detected during screening are so slow-growing that they may never have caused problems or been a risk to the patient. Once diagnosed with cancer, most patients choose to have it treated, even if advised that their cancer is so mild that they should consider watching it rather than immediate treatment. Unfortunately, all treatments for prostate cancer have a significant risk of side effects. Side effects can include urinary incontinence, erectile dysfunction, or bowel dysfunction.

Taking both the benefits and drawbacks of PSA testing into consideration, Dr. McGinnis urges physicians not to eliminate screenings altogether, but rather to initiate smarter screenings and avoid over-treating low-risk cases of the disease.

“While I agree that there are some problems with PSA tests as a tool to find cancer, it’s a disservice to men out there to say that no one should be screened,” he says. “PSA testing really has saved some men’s lives.”

Whether or not you are eligible for a PSA test is a conversation you should have with your doctor. To find a urologist in your area, visit our website.

Posted by Main Line Health on 3/19/2013 8:36:37 AM

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