kidney and urinary tract disorders
Prostate Cancer
Screening for Prostate Cancer
Because prostate cancer is common and sometimes fatal, and because symptoms may not develop until the cancer has become advanced, many doctors offer screening tests to men with no symptoms. To screen for prostate cancer, doctors do a digital rectal examination (DRE) and a blood test to measure prostate-specific antigen (PSA) levels. If the prostate gland is hard, irregularly enlarged, or has a lump or if the PSA level is elevated, prostate cancer is more likely. However, PSA levels can be misleading. The PSA level can be normal when prostate cancer is present and can be elevated for reasons other than prostate cancer. PSA levels normally increase with age and with disorders such as Benign Prostatic Hyperplasia (BPH) and Screening has the advantage of finding aggressive cancers early—when they might be cured. However, experts disagree about whether and when screening is helpful for a variety of reasons: Screening tests may be positive in many men who do not have cancer. Some prostate cancers grow so slowly that they may not require treatment. Rarely, some more aggressive cancers may not be detected by standard PSA testing. Screening using the PSA blood test is considered in all men older than 50 and in some who are younger who have risk factors, such as being Black or having a family history of prostate cancer. Benefits of screening may decrease with age. The United States Preventive Services Task Force recommendations indicate that men aged 55 to 69 (but not those 70 or older) should discuss with their doctor the benefits versus harms of screening with the PSA blood test. Screening may find cancers that would probably not hurt or kill a man even if they were never detected. In such cancers, the side effects of treatment (for example, Erectile Dysfunction (ED) or Because the best course of action is still not clear and because men may have different values and preferences, the harms and benefits of screening, biopsy, and treatment should be discussed with their doctor. For example, men who would rather risk a substantial likelihood of side effects resulting from treatment than even a very small risk of death caused by a prostate cancer may choose to be screened. Men who would not want to risk the side effects of treatment unless it was absolutely necessary may choose not to be screened. 