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The American Cancer Society is urging doctors to make clearer to men that the test used to screen for prostate cancer has limits and may lead to unnecessary treatments that do more harm than good.

The cancer society has not recommended routine screening for most men since the mid-1990s, and that is not changing. But its new advice goes farther to warn of the limitations of the PSA blood test that millions of American men get now. It also says digital rectal exams should be an option rather than part of a standard screening.

American men have long been urged to have prostate cancer screenings, but over time studies have suggested that most cancers found are so slow-growing that most men could have avoided treatment.

The new cancer society recommendations could be “game changers” in two respects, said Dr. John Davis, a urologist who directs prostate cancer screening programs for the University of Texas M.D. Anderson Cancer Center in Houston.

Men at average risk should get detailed information around age 50, the society recommends. Men at higher risk, including African-Americans and men with a father or brother who had prostate cancer before age 65, should get the information beginning at age 45. Men with more than one close relative with prostate cancer before 65 should get such information at age 40.

For men who want to be screened regularly, the new guidelines recommend every other year if the PSA reading is less than 2.5, a measure of prostate specific antigen per milligram of blood.

Annual tests are recommended for 2.5 or higher and a 4 suggests consideration of a biopsy. The urological association considers the cancer society’s advice too simplistic and says it’s important to consider any rapid rise in PSA results.

Source: ACS

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