Prostate Cancer: To screen or not to screen
9/6/2016 by Dr. Joseph Furst
There's a saying in medicine that if a man lives long enough, he will get prostate cancer. There's another saying that if a man is diagnosed with prostate cancer older than age 75, he likely will die of something else.
In 2016, there will be an estimated 180,890 new prostate cancer cases diagnosed, and 26,120 deaths from this cancer. Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. One in seven men will be diagnosed with prostate cancer, but one in 39 men will die of it.
As common as prostate cancer is, the U.S. Preventive Services Task Force doesn't recommend routine screening. This is because a lack of a lack of screening method that is both sensitive and specific.
The Prostate-Specific Antigen (PSA) blood test has been used in the past for screening, but has become controversial. It's reasonably sensitive, but it's less specific than the ideal screening test. Additionally, screening may result in detection of a cancer that leads to treatments that may cause harm, whereas the cancer itself may never at been destined to cause a problem. At this point, it's just hard to tell which cancers we need to identify.
So what do men do? Those at higher risk for prostate cancer, including black men and men with a family history of prostate cancer, should have a conversation with their primary care provider regarding the pros and cons. The use of the PSA and other screening methods is evolving.
Other ways to reduce risk for prostate cancer include a low-fat diet, eating more plant-based fats rather than those from animals, eating more fish, and increasing fruits and vegetables in your diet. Exercising most days of the week is important as well.
Dr. Joseph Furst is a family physician at Mayo Family Clinic Southeast and medical director for Mayo Clinic Express Care.