Cancer Data Access System
Additional information about PLCO can be found on the Cancer Data Access System website, including a trial summary.
CDAS also serves as a portal for PLCO datasets, including:
- Study data for screening, diagnosis, treatment, and mortality analyses for prostate, lung, colorectal, and ovarian cancers
- Study data for incidence and mortality analyses for cancers of 14 other common sites of interest
- Additional data from ancillary studies
- Chest x-ray and pathology images and
What Is Screening For Prostate Cancer
Some men get a PSA test to screen for prostate cancer. Talk to your doctor, learn what is involved, and decide if a PSA test is right for you.
Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.
If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.
There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.
Prostate Cancer Malpractice Lawyers In New York
The only thing worse than being diagnosed with prostate cancer is learning that it should have been caught sooner. If you suspect your prostate cancer should have been diagnosed sooner, call the team at the Porter Law Group for a free case evaluation.
Doctors have at their disposal state-of-the-art tools to identify and diagnose prostate cancer at an early stage. But too often, they either fail to order the appropriate tests, order a test but dont read the results, or fail to interpret the test results correctly. This sort of medical malpractice can have devastating effects. Instead of being diagnosed early, when treatment can work, cancerous tumors are allowed to grow and spread for months, or even years.
The lawyers at the Porter Law Group have secured millions of dollars* for men whose prostate cancer diagnosis was delayed. We can recover compensation for you if your doctors:
- failed to test prostate-specific antigen levels in your blood
- failed to properly read or interpret your PSA test results
- failed to order other screening tests
- failed to perform a digital rectal exam
- failed to order MRI or transrectal ultrasound imaging studies
- failed to properly learn and respond to your pertinent family medical history
- failed to order appropriate follow-up tests
- failed to appropriately educate you about the risks of not being screened
Our lawyers and team of board-certified medical experts are here to give you the answers you and your family deserve.
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Ask About Screening For Bowel Cancer
Early detection of bowel cancer greatly improves chances of successful treatment. Your risk of bowel cancer increases with age. If you are over age 50, you should be tested for bowel cancer every two years.
The National Bowel Screening Program, using FOBT, is offered free to all Australians aged 50-74 every two years. Cancer Council urges all eligible Australians to participate. Screening kits usually arrive within six months of your birthday.
Some people have known risk factors that put them at increased risk. If you do, your doctor will talk to you about regular surveillance.
Environmental Radiation Exposure Dna Damage And Risk Of Malignancies
The risk of malignancy after radiation varies between different animals and between different strains of the same species, and even tissues vary in their sensitivity to radiation. Suit and colleagues reviewed the data on the effects of radiation in cell cultures, animal studies and in humans exposed to radiation. In cell cultures, a linear increase of transformations was noted as radiation increased from 1 to 7Gy .
Older studies have suggested a long latency period between radiation exposure and the development of clinical cancer although the increased risk is life long. Quilty and Kerr reported the median latency period between the delivery of pelvic radiation and the diagnosis of bladder cancer to be 30 and 16.5 years using low-dose and high-dose radiation, respectively .
However, recent studies have estimated a mean latency period of 5 years from radiation exposure to radiation-induced cancer . Studies on patients who survived the release of radioactivity after the accident at the Chernobyl nuclear facility show an increase in DNA damage, DNA damage-repair mechanisms, and urinary bladder lesions .
The same studies have shown that a 73% rate of urothelial carcinoma in a cohort of patients with benign prostatic hyperplasia or chronic cystitis, while the rate of bladder dysplasia was 97%, compared with no carcinomas and a 27% rate of dysplasia in unaffected areas . The incidence of bladder cancer increased from 26.2 to 43.3 per 100,000 between 1986 and 2001 .
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Understanding Your Psa Test Results
PSA is usually measured in nanograms per millilitre of blood . There is no one PSA value that is considered normal. The value varies from man to man and increases as you get older. Most men have a PSA level of less than 3ng/ml.
Your GP or specialist may suggest further tests if your PSA level is higher than would be expected for someone of your age. Talk to your doctor about your PSA level and what this means for you.
Inclusion Criteria And Endpoints
For prostate cancer screening, inclusion criteria were limited to all-male respondents aged 55 years who answered the question whether they had ever had a PSA test. For colon cancer screening, the inclusion criteria were limited to all men and women aged 50 years who answered the question whether they had undergone a colonoscopy. The primary outcomes of the study were self-reported occurrence of PSA blood testing and colonoscopy for prostate and colon cancer screening, respectively.
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Summary Of Recommendations For Clinicians And Policy
The recommendations apply to all men without a previous diagnosis of prostate cancer.
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For men aged less than 55 years, we recommend not screening for prostate cancer with the prostate-specific antigen test.
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For men aged 5569 years, we recommend not screening for prostate cancer with the PSA test.
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For men 70 years of age and older, we recommend not screening for prostate cancer with the PSA test.
Recommendations apply to men in the general population. This includes men with lower urinary tract symptoms and those with benign prostatic hyperplasia. About 25% of men in the screening trials had lower urinary tract symptoms, and benign prostatic hyperplasia is not a risk factor for prostate cancer.49
Groups at increased risk of prostate cancer and of dying from it include men of black race and men with a family history of prostate cancer. There are no trial data showing that the benefits or harms of screening differ in these populations, as compared with men in the general population. However, clinicians may wish to discuss the benefits and harms of screening with men at increased risk of prostate cancer, with explicit consideration of their values and preferences.
Recommendations do not apply to the use of the PSA test for surveillance after diagnosis or treatment of prostate cancer.
Prevalence Of Prostate Cancer
An estimated 191,930 new cases of prostate cancer will occur in the United States this year. Further it is expected that 33,330 deaths will occur this year due to prostate cancer. This is the second leading cause of cancer death in men.
Men age 40 and older who have at least a 10-year life expectancy should talk with their health care professional about having a baseline digital rectal exam of the prostate gland and a prostate-specific antigen blood test.
Most prostate cancers are discovered in the local stage the 5-year relative survival rate for patients whose tumors are diagnosed at the earliest stages of the disease is nearly 100%.
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Repeating The Psa Test
A mans blood PSA level can vary over time , so some doctors recommend repeating the test after a month or so if the initial PSA result is abnormal. This is most likely to be a reasonable option if the PSA level is on the lower end of the borderline range . For higher PSA levels, doctors are more likely to recommend getting other tests, or going straight to a prostate biopsy.
Getting A Prostate Biopsy
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.
For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.
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Men: Cancer Screening Exams By Age
These exams are for men at average risk of cancer.
Take this checklist to your next doctors appointment. Your doctor can help you develop a more tailored screening plan if needed.
These exams are for men at average risk of cancer. If you believe you may be more likely to develop cancer because of your personal or family medical history, visit our screening guidelines page to learn about exams for men at increased risk.
Ages 40-49
- Beginning at age 40, you should speak with your doctor about the benefits and limitations of prostate screening.
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year starting at age 45 to check for prostate cancer if you are African American or have a family history of prostate cancer.
Ages 50-75
- If you choose prostate cancer screening, you should get a digital rectal exam and PSA test every year to check for prostate cancer
- Colonoscopy every 10 years or virtual colonoscopy every 5 years to check for colorectal cancer
Age 76 and older
If youre age 76 to 85, your doctor can help you decide if you should continue screening. MD Anderson does not recommend cancer screening for men age 85 and older.
All Ages
Speak with you doctor about cancer screening exams for lung and skin cancers. Exams are available for those at increased risk.
Regardless of your age, practice awareness. This means you should be familiar with your body so youll notice changes and report them to your doctor without delay.
Benefits And Harms Of Treatment
Two RCTs27,28 showed that radical prostatectomy reduced prostate cancer mortality among men with symptomatic early prostate cancer. Cohort studies reported decreased prostate cancer mortality2934 and all-cause mortality2936 associated with radical prostatectomy. There was no trial evidence to indicate that radiation therapy improves clinical outcomes in men with prostate cancer, although pooled analyses of observational data suggested that radiation therapy reduces prostate cancer mortality and all-cause mortality.3037 No studies showed that hormonal therapy decreased all-cause or prostate cancer mortality, and no studies of the effect of cryotherapy or high-intensity focal ultrasonography on all-cause or prostate cancer mortality were identified.13
In addition, between 11% and 21% of men will experience short-term postoperative complications, such as infection, additional surgery and blood transfusions.28,4446 Trial data indicate that radiation therapy increases the risk of urinary incontinence47 and erectile dysfunction.3942 Combined radiation and hormonal therapy also increases the risk of bowel and erectile dysfunction.13 Hormonal therapy has been shown to increase the risk of erectile dysfunction , but not urinary incontinence .13
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A Cancer Prevention Plan For Men
Finding cancer early improves your chances of successful treatment and long-term survival.
Look for:
- lumps, sores or ulcers that don’t heal
- unusual changes in your testicles changes in shape, consistency or lumpiness
- coughs that don’t go away or show blood, a hoarseness that persists
- weight loss that can’t be explained
- moles that have changed shape, size or colour, or bleed, or an inflamed skin sore that hasn’t healed
- blood in a bowel motion
- persistent changes in toilet habits
- urinary problems or changes.
These symptoms are often related to more common, less serious health problems. However, if you notice any unusual changes, or these symptoms persist, visit your doctor.
Cancer Incidence By Race And Ethnicity
Overall cancer incidence rates decreased for all racial and ethnic groups between 2013 and 2018, with the largest decreases among AIAN and Black people . This decrease eliminated a disparity in overall cancer incidence for Black people, who had the highest rate of new cancers in 2013 but had a similar cancer incidence rate as White people in 2018. Among the four leading types of cancer, rates of new lung and bronchus and colon and rectum cancer decreased across all racial and ethnic groups from 2013 to 2018. Rates of new prostate cancer cases decreased for Black, Hispanic, and AIAN people, while they remained fairly stable for White and Asian and Pacific Islander people over the period. The decreases narrowed disparities in colon and rectum and prostate cancer incidence rates for Black people over the period. New female breast cancer rates also decreased for AIAN and Black people, while there were small increases in the breast cancer incidence rate for other groups.
Patterns of cancer incidence by race and ethnicity vary across cancer types. Female breast, prostate, lung and bronchus, and colon and rectum cancers had the highest rates of new cancers in 2018. Although White or Black people had the highest incident rates across these cancer types, patterns of incidence by race and ethnicity varied by type :
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Screening Information For Prostate Cancer
Screening for prostate cancer is done to find evidence of cancer in otherwise healthy adults. Two tests are commonly used to screen for prostate cancer:
Digital rectal examination
A DRE is a test in which the doctor inserts a gloved, lubricated finger into the rectum and feels the surface of the prostate through the bowel wall for any irregularities.
PSA blood test
There is controversy about using the PSA test to look for prostate cancer in people with no symptoms of the disease. On the one hand, the PSA test is useful for detecting early-stage prostate cancer, especially in those with many risk factors, which helps some get the treatment they need before the cancer grows and spreads. On the other hand, PSA screening may find very-slow-growing prostate cancers that would never threaten someone’s life. As a result, screening for prostate cancer using PSA may lead to treatments that are not needed, which can cause side effects and seriously affect a person’s quality of life.
ASCO recommends that people with no symptoms of prostate cancer and who are expected to live less than 10 years do not receive PSA screening. For those expected to live longer than 10 years, ASCO recommends that they talk with their doctor to find out if the test is appropriate for them.
Other organizations have different recommendations for screening:
If Screening Test Results Arent Normal
If you are screened for prostate cancer and your initial blood PSA level is higher than normal, it doesnt always mean that you have prostate cancer. Many men with higher than normal PSA levels do not have cancer. Still, further testing will be needed to help find out what is going on. Your doctor may advise one of these options:
- Waiting a while and having a second PSA test
- Getting another type of test to get a better idea of if you might have cancer
- Getting a prostate biopsy to find out if you have cancer
Its important to discuss your options, including their possible pros and cons, with your doctor to help you choose one you are comfortable with. Factors that might affect which option is best for you include:
- Your age and overall health
- The likelihood that you have prostate cancer
- Your own comfort level with waiting or getting further tests
If your initial PSA test was ordered by your primary care provider, you may be referred to a urologist for this discussion or for further testing.
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Factors Contributing To Racial Cancer Disparities
Research suggests that racial cancer disparities are driven by a combination of inequities in health coverage and access to care, social and economic factors, and care and treatment that are rooted in racism and discrimination. Moreover, some research suggests that hereditary risk and genetic determinants for specific subtypes of cancer, in addition to environmental influences on genetic expression, may also explain a portion of disparities.
What Is The Psa Test
PSA stands for prostate specific antigen. Its a protein made by both normal and cancerous prostate cells. It’s normal for all men to have some PSA in their blood.
A high level of PSA can be a sign of prostate cancer. But your PSA level can also be raised because of other conditions that aren’t cancer. This includes:
- a urine infection
- a benign enlarged prostate
The PSA test can also miss some prostate cancers. Research has shown that 1 in 7 men with a normal PSA level have prostate cancer. And that 1 in 50 men with a normal PSA level have a fast growing prostate cancer.
Because of this, the PSA test on its own is not recommended as a screening test for prostate cancer. But men over 50 can usually ask their GP for a PSA blood test if they want. Your GP will explain the potential benefits and risks of having a PSA test.
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