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The pros and cons of prostate cancer screening

When deciding whether to get tested for prostate cancer, it’s important to look at the latest research and expert recommendations. Then you can feel confident that you’re making a decision that is right for you.

The best place to start is at your primary care provider’s office. Men should have a thoughtful discussion with their provider about the pros and cons of prostate cancer screening. Here’s a look at some key issues to cover.

What is a PSA test?
Cells in the prostate gland make a protein called prostate-specific antigen (PSA). Both healthy and cancer cells make PSA. The protein is found mostly in semen, but it’s also in blood.

PSA tests look for possible prostate cancer. They are ordered mainly to screen men who are asymptomatic. They’re also used to test men who exhibit possible cancer symptoms.

Although the chance of having prostate cancer increases with a higher PSA level, there is no magic number that determines whether you have prostate cancer.

Pros of prostate cancer screening
Early prostate cancers typically don’t cause symptoms, so most are found as a result of screening. Early-stage cancers are likely to be easier to treat.

Men who opt to test for prostate cancer should do so at age 50 if they are at normal risk for the disease. If you are African American or have a father or brother diagnosed with prostate cancer at an early age, start screening at age 45. If you’re at even higher risk, with more than one first-degree relative who’s had prostate cancer, start testing at age 40. Your provider can tell you if you’re at normal or high risk for the disease.

Cons of prostate cancer screening
The PSA test is not a perfect test for early detection. It can result in inaccurate or unclear results. For example, most men who do not have prostate cancer have a PSA level under 4 nanograms per milliliter (ng/ml) of blood, but a level under 4 is not a guarantee that you don’t have cancer.

The PSA test can also miss some prostate cancers, and it can identify some that don’t need treatment. Some prostate cancers grow very slowly and would never need treatment. The PSA test can lead to overdiagnosis and unnecessary testing and treatments that can have negative side effects.

It’s your decision
Start a conversation with your primary care provider to determine if screening for prostate cancer is best for you.

Source: American Cancer Society

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