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Should you be examined for prostate cancer? Advice of a doctor



Whether or not I should be screened for prostate cancer is a question I have been asked many times since the US Preventive Task Force has recommended routine prostate cancer screening.

The main debate surrounds the PSA test (Prostate Specific Antigen) – a blood test that detects increased activity in the prostate. It was an important screening blood test, but it can lead to false positive results. This is because there are several issues that can directly affect PSA, not just cancer – such as infection, irritation and benign enlargement. What's next is a biopsy. It is uncomfortable and carries a low risk (4 to 7 percent) for complications.

This does not mean that you can completely skip prostate screening. In the US, about 200,000 men are diagnosed with prostate cancer every year and about 30,000 die from it. You and your doctor need to determine which monitoring is right for you.

2If you are a man between the ages of 50 and 70 who are ill or are African American, you may want to consider PSA testing. For otherwise healthy men over 40 who have not yet been diagnosed with cancer, a digital rectal exam may be sufficient. My concern is that men will completely dispense with prostate cancer screening because of questions about the recommendations. Newer blood tests, genetic marker tests and even MRI scans are used.

It's your health, so think about a plan with your doctor who is responsible but not overly alarmed.

Do you have a question for Dr. med. Choi? Email him at AskDrChoi@mensjournal.com .

Benjamin Choi, MD, is a urologist in New York City and clinical assistant professor of urology at Weill Cornell Medicine.


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