Screening Standards

Nationally, prostate cancer screening recommendations are in flux. Alta Bates Summit Medical physicians typically recommend men should have a base line prostate screening, including both a blood test and medical examination, beginning at age 50. Men in high risk groups, African American men or men with family history of prostate cancer, should have a base line screening at an earlier age. Please talk to your physician to find out when you should be screened for prostate cancer.

American Urological Association Foundation (AUA)

The American Urological Association Foundation is concerned that recent studies about prostate specific antigen (PSA) testing may present conflicting information to patients about the value of this critical prostate-cancer screening test. The benefits of regular screening and early detection should not be discounted in the overall population. The AUA Foundation believes that the decision to screen is one that a man should make with his doctor following a careful discussion of the benefits and risks of screening. In men who wish to be screened, the AUA recommends getting a baseline PSA, along with a physical exam of the prostate known as a digital rectal exam (DRE) at age 40.

American Cancer Society (ACS)

The American Cancer Society does not support routine testing for prostate cancer at this time. The ACS does believe that health care professionals should discuss the potential benefits and limitations of prostate cancer early detection testing with men before any testing begins. This discussion should include an offer for testing with the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who are at average risk of prostate cancer and have at least a 10-year life expectancy.

Following this discussion, those men who favor testing should be tested. Men should actively take part in this decision by learning about prostate cancer and the pros and cons of early detection and treatment of prostate cancer.

This discussion should take place starting at age 45 for men at high risk of developing prostate cancer. This includes African American men and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).

This discussion should take place at age 40 for men at even higher risk (those with several first-degree relatives who had prostate cancer at an early age).

If, after this discussion, a man asks his health care professional to make the decision for him, he should be tested (unless there is a specific reason not to test).

Prostate Conditions Educational Council (PCEC)

The Prostate Conditions Educational Council (PCEC) encourages men to "Choose to Know - and Know to Choose." This means they should choose to know their PSA values, just as they would their cholesterol, and know that there are many choices and variables in determining if they need a biopsy and subsequent treatment if cancer is found.

The organization recommends a baseline prostate health assessment, including PSA and digital rectal exam (DRE), for all men at 40 years of age and at 35 for men at high risk (including those with a family history of prostate cancer and African-American men).

Based on this assessment, men with a PSA of less than 1ng/ml should begin annual screening starting at age 50. Those who have a PSA greater than 1ng/ml should discuss additional testing and screening with their doctor. The PCEC recommends annual screenings for these men. However, the PCEC does not advocate for screenings if a man's life expectancy is less than 10 years.

Reviewed 02/2010