When Should Men be Screened for Prostate Cancer?

Dr. Nelson talks about when men should be screened for prostate cancer

462284491Prostate cancer is the most common solid tumor in men in the United States. 

Approximately, 230,000 men are diagnosed every year with prostate cancer, about 30,000 men a year die from prostate cancer. This has significantly decreased almost 50% from what it was 20 years ago when doctors started looking and screening for a prostate cancer.

Early screening is very important. It just may save your life. The earlier that prostate cancer is detected, the more treatable it is.

In this video, Dr. Nelson gives an overview of when men should be screened for prostate cancer.

Video Transcript

Roscoe Nelson MD:  Prostate cancer is the most common solid tumor in men in the United States.  Approximately, 230,000 men are diagnosed every year with prostate cancer, about 30,000 men a year die from prostate cancer which is significantly decreased almost 50% from what it was 20 years ago when we started looking and screening for a prostate cancer.  A person should be screened for prostate cancer after a discussion with his physician.  An informed consent and then understanding of what it means and what the result for me is a very important to understand what the results, what you can do with the results.  I recommend patients with strong family history those of African-American descent and people who are otherwise at high risk that have more than a 10-year life expectancy be screened once at age 40 and then at least early after age 50. 

Many men with low PSAs and low risk for prostate cancer can be screened less often after 50 years old, but should still be followed.  Often times, I am asked by a patient’s wife should my husband be screened for prostate cancer and that goes back to the answers I gave before, do they have risk, do have longer than 10 years to live, what your feelings are, what would you do if you found out you had prostate cancer.  My answer is usually yes, more information is good.  One of the things, you need to watch out for is you may have to stand up for yourself and asked to be screened because of the controversies of screening for cancer, some doctors may not offer it, think about your PCP, your primary care physician, and all the things they need to do it may be low on their list.  So, if you are worried about it, if you want to get check, don’t be shy, ask him to check, check your PSA, get your digital rectal exam both are important. 

In the last few years, there has been some controversy as to whether we should screen for prostate cancer.  We get conflicting evidence.  We get can conflicting recommendations from different organizations and it is difficult even as a physician, but more so as a patient to understand should we be screening for prostate cancer.  The US Preventive Service Task Force, a government appointed organization that is recently recommended that we not check for prostate cancer.  One of the reasons that they used were two studies that were performed in the U.S.  These studies were five to six-year studies relatively short-term to look at do people survive because they were screened for prostate cancer and their conclusion was no.  We also know from some longer studies typically that were done in Europe that if you follow those same patients out for 12 to 15 years that you do see a survival advantage. 

There is somewhere in the middle that we need to come to rest.  We should not be screening everyone the 80-year-old man on oxygen who has just had his heart operated on and should not be screened for prostate cancer, but the 50-year-old man whose father died of prostate cancer, he should be screened, he is at a high risk of dying of prostate cancer.  We have to find a middle ground somewhere where we can screen those who are going to benefit from screening and treatment of prostate cancer and not screen and potentially overtreat those who are not in need of treatment.

Roscoe Nelson
Dr. Roscoe Nelson is certified by the American Board of Urology and a Fellow of the American College of Surgeons. He completed his residency at the University of California, Davis and his doctorate of medicine at the University of California, San Diego. Dr. Nelson is nationally recognized and ranked among the nation’s and Arizona’s top physicians and has won numerous awards including the 2008 through 2012 Patients’ Choice Award.


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