Is regular prostate cancer testing appropriate for everyone?

Until recently, we simply didn’t have  a good answer to this question. The only truly accurate answer that we used to be able to offer was, “Maybe.”

As discussed elsewhere on this site, data from the Tyrol region of Austria and from King County in Washington state suggest (but cannot absolutely confirm) that population screening for prostate cancer can reduce overall prostate cancer-specific mortality.

However, data from two recently published studies (from the PCLO trial and the ERSPC trial) have suggested that regular testing of asymptomatic men with PSA and DRE tests can provide only a very limited ability to affect the long-term survival of men compared to irregular or no testing at all. Perhaps worse, we are also clearer that treatment of prostate cancer with invasive methods such as surgery and radiation therapy — and others — comes with an unacceptably high risk for chronic and long-term adverse effects (most particularly urinary incontinence and erectile dysfunction).

As of today, at least we are clearer that the only option for each man is to make his own decisions about regular (or even occasional) PSA and DRE testing if he is concerned about his risk for prostate cancer. The “New” Prostate Cancer InfoLink recommends that decisions about such testing are best taken in consultation with the individual patient’s physician(s). There is no absolute guidance about regular prostate cancer testing that is appropriate for everyone.

You may also want to be aware of the early data that suggests the possibility that a single PSA test level, taken from men in early middle age (i.e., between 35 and 50), may provide an indicator of long-term risk for prostate cancer over the next 25 years.

Content on this page last reviewed and updated May 4, 2009.
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