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Sorting Through the Prostate Cancer Screening Controversy

There’s a battle of opinions waging in the medical community that has men older men (and their doctors) confused on just how to proceed with prostate cancer screening. A simple blood test, once the gold standard for early detection, has been taken off the recommendation table as of late. A replacement, however, hasn’t yet been found, leading many to wonder just how to effectively screen for this cancer that is the second leading cause of cancer-related deaths for American men.

While there’s no simple answer to the question, men will find they can work with their doctors to create a more individualized approach. The blood test in question is called the prostate-specific antigen test. This tests looks for a specific protein in blood that may signal the presence of prostate cancer. The problem is that this protein may also have other causes, giving rise to false positives that ultimately lead to invasive biopsies that aren’t always necessary.

It’s a conundrum to be sure. Doctors on one side of the aisle want to spare their patients from unnecessary further testing by taking the PSA off the table for all but higher-risk cases. Doctors on the other side worry that cases that do develop in low-risk men are now going undetected and untreated. Formal recommendations have changed to remove the PSA from the routine for low-risk patients. Some doctors continue to recommend the test anyway.So, what’s a man to do?

The best bet is to work directly with a healthcare provider to gauge individual risk. Screenings, including the PSA test, will generally begin in the 40s for men who are at higher risk, such as those with a family history of prostate cancer. For men in a low risk category, screening should begin around the age of 50. If prostate cancer is a concern, the PSA can still be given in lower risk cases. The decision to proceed should be made between a man and his doctor.