To screen, or not to screen: that is the question. Whether men should get tested for prostate cancer when they have no symptoms is a long-running debate within the medical community.
There is good evidence, according to the Centers for Disease Control and Prevention (CDC), that the current prostate specific antigen (PSA) test approved in 1986 by the Food and Drug Administration to screen for prostate cancer can detect the disease in its early stages. Evidence, however, is mixed and inconclusive about whether early detection actually saves lives. A study published in the Jan. 9, 2006, issue of the Archives of Internal Medicine found that screening with the PSA test does not cut down on deaths from the disease. Moreover, it is not clear whether the benefits of screening outweigh the risks of follow-up testing and cancer treatments.
At the same time, evidence, such as a drop in the prostate cancer death rate--which some say could be due to improved treatments--suggests that early PSA testing may be saving lives. There are no definitive answers.
According to the National Cancer Institute (NCI), other than skin cancer, prostate cancer is the most common form of cancer and the second leading cause of cancer-related deaths among men in the United States. But doctors' recommendations on screening for the disease vary. Some encourage annual screenings for men older than age 50; others recommend against routine screening. American Cancer Society (ACS) Screening Director Robert Smith, Ph.D., says that the January Archives of Internal Medicine study "isn't strong enough to say definitively that prostate cancer screening isn't valuable."
The controversy, meanwhile, is contributing to a growing quandary for doctors and their patients: what's a man to do?
Until there is more evidence and, perhaps, a scientific consensus of the screening benefits, most doctors and medical organizations, including the NCI, the ACS, and the CDC, agree that men should learn all they can about what is known and what is not known of the benefits and limitations of early detection and treatment for prostate cancer, so that they can make their own informed decisions.
Cancer screening is just one health concern related to the prostate--a very important part of the male reproductive system. As men age, the prostate may become a source of troubling, often inconvenient problems that can, but don't necessarily, include cancer. And since the symptoms of some noncancerous prostate conditions can mimic cancer, many men who learn they have a problem often assume the worst. In general, growing older raises a man's risk for prostate problems, including cancer.
For these reasons, it is important that men know and understand, in the earliest stages, the changes that can occur in the prostate and could, ultimately, affect their health.