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Should men be screened for prostate cancer?

For years, the answer was no. In 2012, the United States Preventive Services Task Force stopped recommending screening — which is usually done by a blood test — because it produced more harm than good.

But today, that answer has partially changed.

The same task force has tweaked its previous screening guidelines and now recommends men ages 55 to 69 have a conversation with their doctor about the risks and benefits to decide if screening is right for them.

“While prostate cancer screenings can help identify and treat the potentially life-threatening disease, some prostate cancers will stay dormant or could take decades to become a problem,” said Dr. Julio Pow-Sang, chair of Moffitt’s Genitourinary Department. “These cases do not need to be treated and men could have side effects from treatment such as incontinence and erectile dysfunction. There are also the psychological effects associated with a false positive test, as over half of men who undergo a biopsy for an elevated prostate-specific antigen (PSA) prove negative for cancer.”

The committee based its decision on new research that says PSA screening for men in the 55-69 age group could prevent 1.3 deaths and stop three cases of prostate cancer for every 1,000 men screened.

The new guidelines also apply to men at highest risk of prostate cancer, such as African Americans and those with a family history of the disease. According to the American Cancer Society, an African-American man has an 18 percent chance of developing prostate cancer, compared to 13 percent for Caucasian men.  More than 4 percent of African American men will ultimately die from prostate cancer.

Moffitt patient Barney Morris defied those odds and now calls himself a prostate cancer survivor. He says screening caught his cancer not once, but twice.

“Because of my diagnosis, I have realized the importance of being proactive in health care, especially when it comes to screening for prostate cancer,” said Morris. “Had I not had the screening, I probably wouldn’t be here today.”

The task force still finds screening for men over the age of 70 inappropriate because research shows screening causes more harm than benefit for this age group. 

“Prostate cancer screening has been a very controversial topic because there have been different recommendations from different agencies and medical societies,” said B. Lee Green, Ph.D., vice president of Diversity, Public Relations and Strategic Communications at Moffitt. “Men were left confused regarding being screened or not, but these new guidelines now come closer to having all the health and medical professionals on the same page with prostate screening recommendations.”

“Furthermore, these recommendations promote shared decision-making between physicians and their patients, as well as opens avenues for implementing personalized care, particularly for men at high risk of harboring aggressive prostate cancer,” said Dr. Kosj Yamoah, a radiation oncologist in Moffitt’s Genitourinary Department.

Moffitt experts recommend that men should take charge of their health and become well informed regarding the risks and benefits of prostate cancer screening. Learn more about the National Comprehensive Cancer Network, American Urological Association and American Cancer Society guidelines.