Prostate Cancer Screening Ages 55 To 69
This is the age range where men will benefit the most from screening.Thats because this is the time when:
- Men are most likely to get cancer
- Treatment makes the most sense, meaning when treatment benefits outweigh any potential risk of treatment side effects
Most men will get prostate cancer if they live long enough. Some prostatecancers are more aggressive others can be slow-growing. Doctors will takeyour age and other factors into consideration before weighing the risks andbenefits of treatment.
You should ask your doctor how often he or she recommends you get screened.For most men, every two to three years is enough.
Depending on the results of your first PSA test, your doctor may recommendyou get screened less frequently.
What Resources Are Available To Help Me Find Lgbtq
Finding a provider you feel good about working with is always important especially for trans women and nonbinary people.
Some people prefer to work with a provider who specializes in caring for LGBTQ people. You can find a provider by using the GLMA online directory, or by reaching out to friends and family for a recommendation.
Peer groups are another great way to get referrals, or to learn about prostate health. Here are a few that might be helpful:
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Prostate Cancer Foundation of Australia Shine a Light group
Finding Prostate Cancer Early
There is no national screening program for the early detection of prostate cancer. Doctors have different opinions about whether all men without symptoms of prostate cancer should be tested.
There is concern that testing healthy men will cause unnecessary harm and lead to treatments that may not offer long-term benefits. Treatment for prostate cancer can leave men with side effects such as erectile dysfunction and continence issues, which can affect their quality of life.
Testing may identify fast-growing or aggressive cancers that have the potential to spread to other parts of the body and would benefit from treatment. It may also detect very slow-growing cancers that are unlikely to be harmful.
Weigh up all the risks and benefits before deciding whether to be tested for prostate cancer, particularly if you dont have symptoms. Talking to your doctor can help.
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Should You Get Screened For Prostate Cancer
The decision to get screened for prostate cancer is deeply personal. Making that decision begins with knowing the facts.
What Is Prostate Cancer Screening?
The point of any cancer screening is to find cancer before it causes symptoms or spreads. This is especially important when it comes to prostate cancer, as many men dont experience any symptoms in the early, most treatable stages. Screening is usually the only way to find it.
Prostate cancer is the second-most common cancer for men in the U.S. Its also 100 percent treatable if found early.
How Do You Screen for Prostate Cancer?
There are two components of a prostate cancer screening. Your doctor will perform a digital rectal exam to feel for any enlargements or lumps in the prostate. He or she will also do a prostate-specific antigen test.
PSA is a substance your prostate makes. The test measures the level of PSA in your blood. As a general rule, having a high PSA indicates a problem with the prostate.
Need For This Guidance
New Zealand men currently receive conflicting advice about prostate cancer testing and treatment. Some men may benefit from early diagnosis and treatment, but have limited opportunity to access appropriate health services.
Unlike other cancers, prostate cancer often grows slowly. With routine prostate specific antigen testing, many men can be diagnosed with a cancer that is not going to progress during their lifetime. Such a diagnosis may increase mens exposure to unnecessary treatment-related harms.
On the other hand, some men will still develop aggressive and potentially life-threatening prostate cancer. These men may benefit from prompt diagnosis and treatment.
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What If I Am Diagnosed With Prostate Cancer
Many people have been where you are standing. Dont lose hope. More than 3.1 million American men have been diagnosed with prostate cancer and are alive today.
The first thing you should consider doing is to find out about the specifics of your cancer. You should know your stage and grade .
From there you can find out what treatment options you want to pursue, if any. Talk to your doctors. Choose a healthcare team of different specialists, or consult a second opinion. You can also do your own research, or talk to men who have been in your position. Many of our advocates are patients and survivors hear their stories at the video library. Or head to the rest of our website to start some research.
Determining who needs treatment for prostate cancer has evolved with new options to diagnose aggressive vs. indolent disease. Check out our infographic with more information on what genomic and advanced tests are available based on a mans individual cancer.
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What Is A Prostate Cancer Screening Like
A prostate cancer screening can be conducted in one of two ways. The first, a PSA test, is a simple blood draw. The second is a brief rectal exam that takes less than 30 seconds to perform.
“For a screening, if a patient comes and asks for a prostate cancer screening, it begins with a blood test,” said Ehdaie. “It’s a small vial of blood, and then a medical history and physical examination. In the physical examination there will be a digital rectal examination in which the physician’s finger is inserted into the rectum to feel the prostate.”
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Digital Rectal Examination And Psa
Prostate biopsy prompted by abnormal findings on digital rectal exam , such as nodularity or induration of the prostate leads to a diagnosis of prostate cancer in only 15%-25% of cases. This compares with prostate cancer prevalence of less than 5% among men of similar age without abnormal DRE. Although neither accurate nor sensitive for prostate cancer detection, abnormal DRE is associated with a 5-fold increased risk of cancer present at time of screening.
PSA Screening has revolutionized prostate cancer screening. PSA is a serine protease produced by the prostatic epithelium and secreted in the seminal fluid in large quantities. Prostatic disease changes the cellular barriers that normally keep PSA within the ductal system of the prostate and thereby alters serum levels. The level of PSA in serum is increased by inflammation of the prostate, urinary retention, prostatic infection, benign prostatic hyperplasia, prostate cancer, and prostatic manipulation.
Like DRE, PSA is, therefore, neither accurate nor optimally sensitive for prostate cancer screening only 15%-25% of cases with PSA greater than 4.0 ng/dL are found to have prostate cancer on biopsy.
Can You Prevent Prostate Cancer
There are three things that we know can cause prostate cancer:
- Genes: You cant control your genes. Those come from your mom and dad. But there is a genetic test that can tell you whether you are at average, above average or really high risk for prostate cancer. A man who has a family history can determine if it is genetically based. We can use that knowledge to guide our screening and testing.
- Diet: Eat in moderation. Dont overdo the fats, proteins, red meats. Eat colorful fruits, vegetables and whole grains. A healthy diet may help reduce your risk.
- Lifestyle: Some studies have shown that men who are overweight or obese are at higher risk for developing prostate cancer. We live in a stressful society. Particularly, urban societies, like St. Louis, have been associated with a higher risk of prostate cancer. We need to take a more holistic approach to doing the right things to be gentle with ourselves and each other.
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When To Startand Stopscreening
The doctors and researchers who recommend screening argue that cases of prostate cancer found very early can be cured more quickly, with less chance of relapse or spread. Those who recommend against routine screening point to the slow-moving nature of prostate cancer and the side effects of surgical and medical treatment, which can be considerable.
The introduction of PSA screening in the US led to an initial increase in the number of prostate cancer cases diagnosed each year, even though many of these new cases were non-aggressive or low-risk prostate cancer. The issue was not that screening was harmful, it was that many of these low-risk cancers did not necessarily need immediate treatment. It seems strange to say that a patient might be better off leaving cancer untreated, but in some cases, it can be true. For a few years, the United States Preventative Services Task Force recommended against PSA screening. We are now seeing more cases of advanced prostate cancer diagnosed in recent years. This may be a long-tail effect of that USPSTF recommendation. It has now been changed to note that for men aged 55 to 69 years, the decision to undergo PSA screening is an individual one and should be discussed with your doctor. USPSTF continues to recommend against screening for men aged 70 and over.
Prostate Cancer Screening Ages 40 To 54
The PSA test is a blood test that measures how much of a particular protein is in your blood. Its been the standardfor prostate cancer screening for 30 years.
Your doctor will consider many factors before suggesting when to startprostate cancer screening. But hell probably start by recommending the PSAtest.
While the general guidelines recommend starting at age 55, you may need PSAscreening between the ages of 40 and 54 if you:
- Have at least one first-degree relative who has had prostate cancer
- Have at least two extended family members who have had prostate cancer
- Are African-American, an ethnicity that has a higher risk of developing more aggressive cancers
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Healthy People 2030 Target
There is no Healthy People 2030 target related to being screened for prostate cancer. There is a target goal to increase the proportion of men who have discussed the advantages and disadvantages of the PSA test to screen for prostate cancer with their health care provider.
Healthy People 2030 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
What Are The Screening Guidelines For Prostate Cancer
The general recommendation for prostate cancer is to start being examined by your doctor and have a PSA test at the age of 50 if youre a man at average risk for prostate cancer. PSA, or prostate specific antigen, is a protein produced by cancerous and non-cancerous tissue in the prostate.
If you have a family history of prostate cancer, or if youre an African American man, you are at higher-than-average risk for prostate cancer. For these men, the recommendation is to start getting tested at age 40. This is so crucial for prostate cancer, because its all about early detection. If we can find it early, we can cure it.
Not enough men are being screened for prostate cancer. We need to get the word out and we need to rectify this.
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American Cancer Society Recommendations For Prostate Cancer Early Detection
The American Cancer Society recommends that men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening. Men should not be screened unless they have received this information. The discussion about screening should take place at:
- Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years.
- Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative diagnosed with prostate cancer at an early age .
- Age 40 for men at even higher risk .
After this discussion, men who want to be screened should get the prostate-specific antigen blood test. The digital rectal exam may also be done as a part of screening.
If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the mans general health preferences and values.
If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:
- Men who choose to be tested who have a PSA of less than 2.5 ng/mL may only need to be retested every 2 years.
- Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher.
What If My Test Results Are Abnormal
If the results of early detection tests like the PSA screening or the digital rectal exam suggest that you might have prostate cancer, your doctor will conduct further testing. The PSA may be repeated, or you may be sent to a specialist for more tests such as a transrectal ultrasound and a prostate biopsy.
In a prostate biopsy, a tissue sample is taken from your prostate. Cancer can only be diagnosed with a tissue sample.
Recent research has yielded additional tests that in addition to the PSA and subsequent DRE and Biopsy that can give a doctor more information on to determine the probability of both finding cancer during a biopsy and determining how aggressive that cancer is likely to be. Read more on those tests.
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If You Want A Psa Test
Although there is no prostate screening programme, men aged over 45 can ask their GP for a PSA test.
If you ask to have the test your GP first explains all the possible benefits and risks. They give you written information to read. Your doctor or practice nurse can answer any questions that you have.
If you still want to have the test after considering the information, your GP or practice nurse will take a blood sample.
If you have the test you should not have
- A urinary tract infection
- Ejaculated for 48 hours beforehand
- Exercised heavily in the previous 48 hours
- Had a prostate biopsy within the last 6 weeks
These things may raise your PSA level.
Your GP may also examine your prostate. They do this by gently putting a gloved finger into your back passage and feeling your prostate gland. They call this digital rectal examination or DRE.
Early Detection Saves Lives
Prostate cancer is the most common cancer affecting Australian men .
Prostate cancer is the growth of abnormal cells in the prostate gland. This gland is only found in males and is about the size of a walnut.
The causes of prostate cancer are not understood and there is currently no clear prevention strategy.
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Tips For Speaking With A Provider About Prostate Cancer
Being transgender can be a barrier to care for many people. If youre trans, you may be less likely to go for regular medical checkups including cancer screenings.
But its important to be proactive when it comes to your prostate health. This could include:
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Educating yourself about prostate cancer
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Talking to your family members about their health history, to understand whether prostate cancer runs in your family
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Putting together a list of questions about your prostate health, to share with your provider
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Being open with your provider about your gender identity
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Taking a friend or family member, if needed, to your providers visits for support
Other Factors That Influence Psa Levels
The PSA blood test alone cannot diagnose prostate cancer. It is possible, although rare, to have prostate cancer without raised PSA levels in the blood. A higher-than-normal PSA level doesnt automatically indicate prostate cancer either. A high PSA level is due to cancer in around one in three cases.
PSA levels can be raised by other factors, including:
- , also known as benign prostatic enlargement .
For this reason, the PSA blood test isnt used in isolation when checking for prostate cancer.
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How Do I Get Screened
The gold-standard test for prostate cancer screening is the PSA test.
The PSA test measures levels of prostate-specific antigen in the blood. PSA is a protein produced by the cells of the prostate. Because cancerous cells tend to produce more PSA, a spike in your PSA level may signify a problem, however, there are other benign conditions that may cause an uptick in PSA. Read more here about how to make sure your PSA test is as accurate as possible. If youre having a PSA test, it can often be added on to other blood work you may be having that day, and you may not need a separate blood draw.
Tracking your PSA over time can be valuable to distinguish a temporary increase from a gradual, yet persistent rise. Even if your level is still within normal range, but is higher than it was the last time it was tested, its worth checking further. After a single high PSA result, often the first step is to repeat the test a couple of weeks later to confirm that it is, in fact, elevated. This should be done at the same lab as the previous test, to avoid fluctuations due to different equipment.
A Brief History Of Psa
PSA was first discovered in the 1970s and was approved in the 1980s by the FDA to monitor prostate cancer recurrence. In 1991, Catalona et al. published a seminal paper in the New England Journal of Medicine showing that PSA was a good predictor of a prostate cancer diagnosis. PSA soon became a widely used screening test throughout the United States for asymptomatic men.
Following this, the incidence of prostate cancer skyrocketed. The figure below from SEER data displays this rapid increase. Prior to routine PSA testing, 1 in 10 men were diagnosed with prostate cancer. After widespread PSA testing, 1 in 6 men were diagnosed with prostate cancer. Corresponding to this, in the mid 90s mortality due to prostate cancer began to decline at a rate of approximately 4% per year, as seen in the graph below. This may have been due to an increase in PSA screening, however, some have suggested it is due to earlier and increasingly aggressive prostate cancer treatments beginning around the same time period.
Prostate cancer incidence and mortality before, during and after the introduction of PSA testing, 1975-2011.
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