Screening for early Prostate cancer
rules are changing in the USA
Prostate cancer is one of the most common cancers in men. In the UK 12,000 men die of prostate cancer each year and the United States 333,830 men will be diagnosed with prostate cancer and 36,320 men will die of the disease. Although there have been some major advances in treatments such as radiotherapy, surgery and new drugs.
The best way to reduce the impact of cancer is adopt lifestyle and nutritional habits and avoid carcinogens reduce the risk of developing it in the first place and slow the rate of progression once established.
Another way to improve cure rates is to pick it up earlier. Prostate cancer screening is an can help but PSA alone is not perfect as it picks up too many false positives and can still miss cancers (false negatives).
The going UK TRANSFORM STUDY is evaluating the effectiveness and and cost effectiveness of using genetic testing, Rapid MRI as well as PSA. It is a 60 million pound investment supported by the government with charities such as Prostate Cancer UK. You can see more about this study in the video below
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Conventional screening
In the mean, time although screening is not approved in the UK, the American Cancer Society have released an updated guideline for prostate cancer screening. The PSA screening is now recommended as:
- PSA-based screening every 2 years for average-risk men aged 50 to 69 years.
- Men at high risk to have screening from age 45 to 69 years
– Black men
– Non-black men with a first-degree relative diagnosed before age 65
– Non-Black men with Multiple first-degree relatives diagnosed at any age - Individualised decision-making on continuing screening is recommended for men aged 70 to 74 years, as the balance of benefits and harms remains uncertain.
- Men with elevated PSA levels (>3.0 ng/mL for men aged 45 to 69 years and 6.5 ng/mL ofor men aged 70 to 74 years) have PSA testing.
- Men with a confirmed elevated PSA should be offered testing by magnetic resonance imaging (MRI) and/or a validated biomarker to guide biopsy decisions.
- Screening is not recommended for men aged 75 years and older. Some men ages 75 to 79 who are very healthy may want to continue screening, especially if their PSA has been rising on previous tests, but this should be discussed with a health-care provider.
- Screening is not recommended for men aged 80 and older and for men who are not expected to live another 10 years.
- Men diagnosed with prostate cancer that has a low risk of growing or spreading should be offered active surveillance as the initial management option.
References and sources:
The guideline update was published by Hoffman et al in CA: A Cancer Journal for Clinicians.
The latest nutritional intervention trial – prostate cancer
Lifestyle tips to reduce the risk of Prostate cancer
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