What to Know About Updated Prostate Cancer Screenings
James Grant, M.D.
| 3 min read
James D. Grant, M.D., is executive vice president an...
Key Takeaways
- Prostate cancer screening guidelines have undergone changes, potentially causing confusion for individuals making health decisions.
- Updated recommendations aim to clarify the benefits and risks of prostate cancer screening for men.
- New treatment guidelines provide more personalized approaches to prostate cancer care, helping individuals make informed decisions about their health.
By: James D. Grant, M.D., Chief Medical Officer, Blue Cross Blue Shield of Michigan
Approximately one in eight men will be diagnosed with prostate cancer in their lifetime, and the majority of these diagnoses are in men who are older than 65.
Early diagnosis is key to survival. When found in an early, localized stage, prostate cancer has a five-year survival rate of more than 99%.
Recommendations and protocols for prostate cancer screening and treatment have evolved throughout the years as the medical community learns from research, clinical practice and shared knowledge.
Changes in recommendations can create confusion for individuals who are making health decisions for themselves. To help that decision-making process, here are some updates on prostate cancer screening and treatment guidelines.
Prostate cancer screening protocol
In general, health screenings are an important part of our overall preventive care plan because screenings can detect problems in the earliest, most treatable stages. This is undoubtedly true with prostate cancer, where screenings such as a prostate-specific antigen (PSA) blood test can detect early-stage, slow-growing prostate cancer. Sometimes, these slow-growing cancers never affect one’s health.
Sometimes, people get false positive results with a PSA test. Older men are more likely to get a false positive result, which can cause them to worry and potentially get a biopsy. Biopsies can be unnecessary and can have complications such as pain or infection.
That’s why both the American Cancer Society and the U.S. Preventive Services Task Force (USPSTF) recommend that men between age 55 to 69 with an average risk for prostate cancer discuss the benefits and risks of prostate cancer screening with their primary care provider (PCP) and make an individual decision that’s best for them.
Men age 70 and older should talk with their PCP to decide whether prostate cancer screening should continue.
Talk to your PCP if you are experiencing concerning symptoms, such as:
- Blood in the urine or semen
- Painful ejaculation
- Pain in the back, hips or pelvis that doesn’t go away
- Pain or burning during urination
- Weak or interrupted urine flow
Watchful waiting protocol for low-risk cancer
During the past 10 to 15 years, the standard practice for slow-growing, early-stage, low-risk prostate cancer is not treatment but active surveillance, which involves close observation and monitoring of cancer over time.
That’s because these favorable-risk, early-stage prostate cancers are highly unlikely to spread beyond the prostate gland and unlikely to affect one’s health. With this type of cancer, treatment with medication, radiation or surgery may not be beneficial and can impose unnecessary harm and stress on the body.
With active surveillance, men will see their urologist regularly and will likely get a PSA test and digital rectal exam at office visits. This allows doctors to monitor the situation to see if cancer is growing.
In Michigan, Blue Cross Blue Shield of Michigan and urologists throughout the state are working collaboratively to collect data and offer guidance to determine which patients should consider active surveillance.
Participants in the initiative, called MUSIC AS, helped clinicians develop a roadmap to guide decisions on which patients are appropriate for active surveillance and to guide the active surveillance process itself.
As part of the initiative, patient guidelines have been developed that outline a schedule and process for active surveillance in an easy-to-understand format.
In summary, decisions about prostate cancer screening and treatment are personal and based on your individual health history and circumstances. Make sure to thoroughly discuss risks and benefits with your PCP before making a decision.
Image: Getty Images
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