¸Û°Äͼ¿â

Prostate cancer is the most commonly diagnosed cancer in men and the second deadliest after lung cancer. The American Cancer Society estimates that, in 2024, nearly 300,000 men will be diagnosed with prostate cancer. Over 30,000 will die from it.

Those are sobering statistics, but there’s a silver lining: early detection of prostate cancer can increase the survival rate. September is Prostate Cancer Awareness Month, so let’s take a look at what screening options are available and how to know if you should get screened.

Early detection can save lives

While tens of thousands of men still die every year from prostate cancer, the death rate has declined by 50% since the early 1990s. There’s no single definitive reason for this decline, but it’s most likely due to a combination of advances in treatment and earlier detection. The average man can’t do much to change the pace of medical advancements, but getting screened for prostate cancer is an easy way to protect yourself from the disease.

"One reason prostate cancer isn’t as deadly as it was 30 years ago is early detection," says Dr. Mark Anderson, a urologist at ¸Û°Äͼ¿â Martha Jefferson Hospital. "You don’t want to be in a situation where you regret having not been screened."

Why is early detection such a game-changer? Catching cancer when it’s still localized in the prostate – before it has a chance to spread to other parts of the body – gives you the best chance of successfully treating it. In fact, over 3 million men who have been diagnosed with prostate cancer at some point in their lives are still alive today.

What does it mean to get screened?

Traditionally, prostate cancer screening involved a digital rectal exam (DRE). This procedure involves inserting a gloved finger in the patient's rectum and checking for an enlarged prostate, a potential symptom of prostate cancer. As you may imagine, DREs were not popular with patients.

Their usefulness as a stand-alone test was also limited. The physician could only detect abnormalities on the back wall of the prostate, not the middle or front. Fortunately, a new test was developed that was less invasive and more accurate: the prostate-specific antigen (PSA) blood test.

Approved by the FDA in 1986, PSA testing involves analyzing a blood sample for a specific protein that is only made by the prostate.

“There was never a prostate-specific blood screening test before the PSA,” says Dr. Anderson. “It was the first test of its kind, and it’s one of the only cancer-screening blood tests.” Anderson adds that DREs are still performed in specific situations, but that the majority of patients will never need one.

PSA tests are typically performed by your general practitioner and are often done as part of a broader panel of blood tests. If your test results show elevated PSA levels – a possible indication that cancer is present – then your doctor can refer you to a urologist for a biopsy to confirm the diagnosis.

“I’m a big believer in PSA testing, and in prostate biopsies, which are a low risk procedure,” says Dr. Anderson.

Who should get screened?

If early detection can save lives, it’s logical to assume that every man should get tested annually. In reality, there’s more nuance to it than that.

First, prostate cancer is very rare in men under the age of 40, so younger men typically don’t need to be tested. Second, not everyone has the same risk factors for prostate cancer. For example, African-American men are twice as likely to die from prostate cancer than white men, and people with a family history of prostate cancer are also at increased risk.

Third, prostate cancer is often, but not always, a relatively slow-moving form of cancer. If you’re not expected to live at least 10 more years because of other health factors, then treating prostate cancer might do more harm than good.

With all this in mind, the ¸Û°Äͼ¿â recommends yearly testing for men who are:

• Age 40 for Black men and those with several first degrees relatives (father, son, or brother) who have been diagnosed with prostate cancer at a young age. This is generally before age 65.
• Age 45 to 50 for those with one first degree family member diagnosed with prostate cancer before age 65.
• Age 50 and older, who are at average risk of developing prostate cancer, have no family history or personal risk factors, and are expected to live 10 years or more.
• Men over aged 70 who have previously undergone prostate screening are encouraged to speak with their provider about continuing prostate screenings. This can be based on age, life expectancy, overall health, family history, and past PSA results.

Have a conversation with your doctor

Ultimately, you should have a conversation with your doctor about prostate cancer screening. They can help you determine if you’re at higher risk for developing the disease and when you should start regular testing.

“I always tell people, it’s better to have more info than less,” Dr. Anderson says. “You should respect prostate cancer, but you don’t have to fear it.”

Learn more about prostate cancer and PSA testing.