To screen or not to screen?

Should all men be screened for prostate cancer? The obvious answer may be yes. However, some suggest a different approach.

The American Cancer Society (ACS), Centers for Disease Control and Prevention, and others recommend first discussing the topic with a healthcare provider.

In 2018, the U.S. Preventive Services Task Force made the following recommendations about prostate cancer screening:

• Men who are age 55 to 69 should make individual decisions about being screened for prostate cancer with a prostate specific antigen (PSA) test.
• Before making a decision, men should talk to their healthcare provider about the benefits and harms of prostate cancer screening.
• Men who are age 70 and older usually do not need screening for prostate cancer routinely.

Cancer screening looks for cancer before it causes symptoms. However, it is still unclear whether the benefits of a screening outweigh the risks for most men, according to the ACS. The ACS cites the following examples:

• A PSA test and digital rectal exam are not 100 accurate. Unclear test results can cause confusion and anxiety, and even lead to biopsies when cancer is not present.
• Even if screening detects prostate cancer, it may be unclear if the cancer is truly dangerous and needs to be treated. Some prostate cancers grow so slowly that they would never cause a man problems during his lifetime.
• Doctors are still studying if screening tests lower the risk of death from prostate cancer.

Until more information is available, the ACS recommends men talk to their primary care provider to determine whether a prostate cancer screening is right for them.