In American men, prostate cancer is the second most commonly diagnosed cancer and the second-leading cause of cancer deaths. The American Cancer Society estimates that about 233,000 new cases of prostate cancer will be diagnosed in 2014, and almost 30,000 American men will die from the disease. About 1 man in 7 will be diagnosed with prostate cancer during his lifetime.
Risk factors for developing prostate cancer include increasing age, family history, ethnicity and diet. The average age of diagnosis is 66, but some cases of aggressive forms of the cancer have been diagnosed in men as young as 30. The American Cancer Society recommends men with an average risk for prostate cancer should discuss screening with their doctors around age 50, while men with high-risk factors, such as African-American men with a family history of the disease, should consider testing as early as age 40.
Prostate Cancer screening is a controversial topic. Despite many studies that show some benefits of screening for prostate cancer with either a PSA test of a digital rectal exam (DRE), it remains unclear whether early screening reduces mortality rates in prostate cancer patients.
In 2012, The United States Preventive Services Task Force (USPSTF) concluded that healthy, low-risk men should not be screened for prostate cancer. False-positive results can cause undue anxiety and stress for the patient and can lead to more testing, including biopsies, which can have negative side effects. Because the screening itself cannot determine which prostate cancers are aggressive and need treatment, most men diagnosed with prostate cancer receive treatment. Since some forms of the slow-growing cancer would have never harmed the patient, experts are concerned about overtreatment. Prostate cancer treatments can result in serious side effects including urinary incontinence, erectile dysfunction, and bowel dysfunction, which outweigh the potential benefits of the screening. The task force encourages men to discuss with their doctors the possible risks and benefits of screening and treatments so that they are better equipped to make informed decisions.
Cancer experts say the focus should be on identifying men who are at high risk for prostate cancer since that group would benefit the most from screening and subsequent treatment. Most experts agree that improved diagnostic techniques along with personalized risk assessments and more informed decision-making by men and their doctors are a more effective way to improve prostate cancer outcomes than to screen every man of a certain age.
September, which is National Prostate Cancer Awareness Month, is the perfect time to increase public awareness of prostate cancer, including personal risk levels, prevalence, approaches to screening and prevention, treatment options, and additional resources available to patients and their families.