Should I Have Prostate Cancer Screening?

Q. I’m in my early 60s and in good health. I am due for my annual physical later this year and keep reading about the controversy regarding prostate cancer screening. Should I plan to get tested for this or not? There doesn’t seem to be a clear answer.

You are right, there is not a clear answer. Proponents say screening using the prostate-specific antigen (PSA) test and other methods saves lives because it detects prostate cancer at an earlier, more curable stage. Opponents say that screening can lead to complications from invasive biopsies and treatment of tumors. The American Cancer Society says that average-risk men with at least a 10-year life expectancy should begin discussing prostate cancer screening at age 50. Men with a PSA less than 2.5 ng/mL may be retested every two years. Men with a PSA greater than 2.5 ng/mL should be screened annually. The Cleveland Clinic Men’s Health Advisor encourages engaging in shared decision-making with your physician, carefully reviewing the pros and cons of prostate cancer screening before saying yes or no. Two basic questions can begin the conversation.

1. How great is my risk of prostate cancer, based on my age, race, and medical history?

2. What are the risks and benefits of screening? Will I benefit from PSA testing, based on my health status, risk factors and life expectancy?

PSA testing, the backbone of prostate cancer screening, is not going away. Talk to your physician, make a decision you are comfortable with, and ask about any other tests that a positive PSA screening may indicate.

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Our expert: Jackson Rainer is a board-certified clinical psychologist who practices with the Care and Counseling Center in Decatur, Georgia, helping people living with chronic illnesses. He consults with a variety of experts to answer a selection of readers’ questions in each issue of Pain-Free Living.

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