Obesity/excess weight, a family history of prostate cancer, and African American race are the driving risk factors of developing prostate cancer. Prostate cancer remains the second leading cause of cancer death in men, killing approximately 34,000 men each year and black men have almost twice the incidence and do have twice the death rates from prostate cancer compared to white men. Since the widespread adoption of PSA screening in the early 90s, there has been a 39 percent reduction in prostate cancer mortality rates; so there is no doubt that PSA screening is successful – when used correctly.
Recently, he American Urological Association (AUA) announced new guidelines for prostate specific antigen (PSA) testing. These guidelines were designed to help urologist, and ultimately patients, reduce prostate cancer mortality by making informed screening decisions. These recommendations were based on comprehensive literature reviews and the strength of the existing evidence.
The recommendations and suggestions for PSA testing concentrate on what age, when, and how often PSA should be tested to optimize the test. Also the AUA focuses on education about the importance of PSA testing and the risks of prostrate cancer.
The AUA recommends against screening in men under age 40. Men under 40 need to be educated about prostate cancer and given a clear understanding of their individual risk factors.
The AUA recommends against routine screening in men of average risk aged 40 to 54 years old—HOWEVER, given the fact that African American men are at greater risks for developing and dying from prostate cancer African American men should begin screening for prostate cancer at the age of 40 years old–a full 15 years earlier than when white men without a family history of prostate cancer should begin screening.
Early diagnosis and treatment are the two most important factors to successfully treating prostate cancer. The AUA recommends against PSA screening in men over age 70 with a life expectancy less than 10-15 years. For men over the age of 70 years old with a projected life expectancy of 10-15 years prostate cancer screening should be part of an overall wellness monitoring assessment.
But men should speak with their doctor about your individual risk factors for prostate cancer and your treatment goals. Through comprehensive education about prostate cancer testing, diagnosis, and treatment options, American men can make well-informed decisions about what’s best for them.
Also visit the Minority Men’s Health Center website to learn more information regarding out Cleveland Clinic Minority Men’s Health Center and/or to schedule an appointment to see me for a consultation: ClevelandClinic.org/mmhc
Charles Modlin, M.D., MBA