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Prostate Cancer Screening

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What is Prostate Cancer Screening?

Screening means checking or testing for a disease or condition in people who have no signs or symptoms of the disease or condition.  For example, we commonly screen for high blood pressure, colon cancer, cervical cancer, breast cancer, etc.  The point of screening is to find the disease or condition early when treatment might be easier and more effective.

Prostate cancer is the second most common (if not the most common) cancer in men in the U.S.  One in 9 men will be diagnosed with prostate cancer in his lifetime.  Therefore, screening for prostate cancer is an important public health effort.

How Do We Screen For Prostate Cancer?

The 2 most commonly used tests for prostate cancer are a prostate exam and a PSA blood test.  Your urologist or primary care doctor performs a prostate exam by placing a gloved finger in the rectum and feeling the back side of the prostate.  Lumps, hard spots or irregularities in the prostate may suggest the possibility of prostate cancer.

PSA is a blood test looking for an enzyme that is produced by the prostate (PSA).  Elevated levels of PSA can be concerning for prostate cancer.  There are other, newer blood and urine tests for prostate cancer but these are not commonly used due to their expense and the fact that they seem to be no better than PSA.  If the prostate exam and/or PSA is abnormal, a prostate biopsy may be recommended.

Who Needs Screening?

Generally speaking, men between the ages of 55 and 69 should consider having a prostate exam and PSA blood test every 2 or 3 years.  There are, however, some men who are at higher risk to have prostate cancer and should be checked more often.  Men whose father or brother had prostate cancer have about a 1 in 5 chance of getting it themselves.  Therefore, these men should consider screening starting at age 40 or 45.  African American men, smokers and men who were exposed to Agent Orange in Vietnam also seem to have a higher risk of prostate cancer.  These men should also consider screening starting at age 40 or 45.  Men over the age of 70 probably do not need screening for prostate cancer unless they are in excellent health or have a strong family history of prostate cancer.  Similarly, men who have serious health problems and limited life expectancy at any age probably do not need prostate cancer screening.

Should I Be Screened for Prostate Cancer?

Our approach to screening for prostate cancer in the US has been controversial for many years.  Many experts think we do too much while others feel that we do too little.  Perhaps the best recommendation is to consider the information in the paragraph above and discuss with your family doctor or urologist what is best for you.  There are advantages and disadvantages to screening.  The obvious advantage is that, if you have prostate cancer, we may find it at an early stage when treatment (if you need it) might be easier and more effective.  Disadvantages include anxiety, testing which may be unnecessary and incorrect tests/biopsy results.

Additional information can be found on the FAQ pages on this website dealing with prostate cancer, PSA and prostate biopsy.

We hope that this answers some of your questions about prostate cancer screening.  Call Gallatin urology (406–551–2306) for an appointment if you need more information or if you are interested in prostate cancer screening.

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