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Screening for Prostate Cancer

Cancer is a frightening possibility—that’s a fact. Today’s medical technology has put powerful tools in our hands. We have tests that can reveal the presence of cancer even before any symptoms are present. That’s news no one wants. The fact is that the earlier you find out about cancer, the greater the likelihood it can be successfully treated. Prostate cancer is highly treatable—but the success of treatments depends in part on catching cases early.

This is why most physicians recommend that men begin routine screening as they enter middle age. Exactly when you begin screening depends on a lot of factors, based on incidence rates among different populations. The following questions can help you decide when to ask your doctor about screening.

Do you have a family history of prostate, ovarian, breast, colon, or pancreatic cancers among your male and female relatives? Some families share tiny genetic mutations that make the development of certain cancers more likely. If you know or suspect this is true of your family, consider screening starting at about 40 years of age. Learn more about genetic factors that affect your risk of developing prostate cancer.

Do you have African ancestry? African American men have a great risk of developing prostate cancer, possibly due to as-yet-unknown genetic factors. If you have ancestors from Africa, consider screening beginning when you are 45 years of age.

How old are you? The risk of developing prostate cancer in men who do not have other risk factors increases with age. If you don’t have any other risk factors, ask your doctor about screening starting at the age of 50 years.

Where do you live? If you live in the northern third of the United States (north of 40° latitude), consider screening a little earlier. Men who live in parts of the world with less natural sunlight have higher rates of prostate cancer incidence and mortality. Consider starting screening a few years earlier than you would considering any other risk factors you have.

Surprisingly, once you are over about 70 years of age, many physicians recommend you stop screening. Many cases of prostate cancer are very slow-moving, and treatments can be taxing. Men over a certain age are more likely to die of other causes, even when they have active prostate cancer. In order to maintain the highest possible quality of life, it might actually be smartest to hold off on dealing with the prostate cancer.

These factors are complicated, and so it’s always best to talk with your doctor about when screening is right for you. The ultimate goal is catching active cancer early so it can be successfully treated, to give you the longest, healthiest life possible.

More about genetic factors and their influence on your risk

Genetic screening can offer powerful insight into your individual risk of developing cancer. Much of the newest research into cancer has focused on identifying genetic mutations that are positively correlated with development of various types of cancer. These genetic mutations can also predict which cancer treatments might work best for an individual patient. Science is revealing that every person’s cancer is unique.

If you have any of the following risk factors, you should discuss them with your doctor and consider genetic screening.

  • A personal history of metastatic prostate cancer
  • A blood relative with a known cancer risk, such as a BRCA mutation or Lynch syndrome
  • Two or more family members with prostate cancer with a Gleason score ≥7
  • One male relative with metastatic prostate cancer and/or one who died of prostate cancer
  • Three more more family members on the same side of the family, with one or more of the following cancers:
    • Breast cancer diagnosed under the age of 50 years
    • Ovarian cancer
    • Pancreatic cancer
    • Colon cancer
    • Any cancer

If genetic screening reveals that you or a member of your family have one of these critical mutations, your genetic counselor will suggest “cascade” screening. This is when many members of a family are screened to determine who else may have the mutation. It really cannot be overstated what a powerful tool these tests are in achieving better health outcomes for families. With more information at hand, each member of the family can begin screening for the types of cancers for which they have the highest risk. The information you learn could save the lives of your brothers and sisters, parents—and your children.

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