What men should know about screening for prostate cancer

by Wayne Combs
U.S. Army Public Health Command

Did you know the U.S. Preventive Services Task Force does not recommend prostate cancer screening for all men? If you don’t know the latest information about prostate cancer screening, you are not alone. Many men don’t. This article will help you understand more about the latest information on prostate cancer screening and help you discuss this issue with your healthcare provider.

What are the latest recommendations for prostate cancer screening?
According to the U.S. Centers for Disease Control and Prevention, there is currently no scientific agreement on the best ways to prevent prostate cancer and not enough supporting evidence to recommend screening in all men. The USPSTF has concluded that the current medical evidence is insufficient to compare the benefits and harms of prostate cancer screening in men younger than age 75 years. The USPSTF also recommends against screening for prostate cancer in men age 75 years or older.

What is prostate cancer?
Prostate cancer is made up of cells that do not grow normally. The cells divide and create new cells that the body does not need, forming a mass of tissue called a tumor. These abnormal cells can sometimes spread to other parts of the body, multiply and cause death.

What causes prostate cancer?
As with many types of cancers, medical experts do not know what causes prostate cancer. They are studying several possible causes.

Who is at increased risk for prostate cancer?
While all men are at risk for prostate cancer, some factors increase risk:
Family history — Men with a father or brother who has had prostate cancer are at greater risk of developing it themselves. 

Race — Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why. Prostate cancer is more common in African-American men than in white men. And, African-American men with prostate cancer are more likely to die from the disease than white men. It is less common in Hispanic, Asian, Pacific Islander and Native American men than in white men.

Age — The prevalence of prostate cancer increases rapidly after age 40.

Can prostate cancer be prevented?
Medical experts do not know how to prevent prostate cancer. But they are studying many factors. They do know that not smoking, maintaining a healthy diet, staying physically active and seeing your doctor regularly contribute to overall good health.

What does “screening” mean?
Screening means looking for signs of disease in people who have no symptoms. So screening for prostate cancer is looking for early-stage disease. The main screening tools for prostate cancer are the digital rectal examination and the prostate specific antigen blood test. However, the DRE and PSA test cannot tell if you have cancer; they can only suggest the need for further tests. Many factors such as age, race, certain medical procedures, an enlarged prostate or a prostate infection can affect PSA levels.

Because of the uncertainty about prostate cancer screening, the CDC recommends that men discuss prostate screening with their healthcare provider. Every man needs balanced information on the pros and cons of prostate cancer to help him make an informed decision about screening.

For more information on prostate cancer, visit the Centers for Disease Control and Prevention:

• www.cdc.gov/cancer/prostate/informed_decision_making.htm.
• /www.cdc.gov/cancer/prostate/pdf/prosguide.pdf.