Prostate cancer screening

What it is

Prostate cancer screening rests on the PSA, and what makes it a hard decision is that its harms are as well described as its benefit. Prostate cancer sits high among the causes of cancer death in men: for 2011 to 2015 the leading causes of cancer death in men were lung cancer at 53.8 deaths per 100,000 per year, prostate cancer at 19.5, colorectal cancer at 17.3 and pancreatic cancer at 12.6.

BPH does not change the screening. In patients with BPH the risk of developing prostate cancer is not higher than that of the general male population, so the standard PSA screening protocol can be followed, and TURP does not reduce the risk of developing prostate cancer.

Causes and risk

The risk factors named are family history and black race. The age band offered is 55-69, and there it is a shared decision-making approach, because of false positives predisposing the patient to invasive procedures and a high detection rate of clinically insignificant cancers leading to overdiagnosis. The method is PSA.