Just as the Ebola epidemic has triggered a false sense of insecurity in North Americans (no reason to panic: we have clean water, electricity, good hospitals, doctors, and medications that can effectively combat its spread), it seems that suggesting guys and skip the regular PSA (prostate-specific antigen) test for prostate cancer has made both medical professionals and patients unnecessarily nervous.
Turns out that a having a larger-than-average prostate, a urinary tract or prostate infection, or a recent medical procedure can elevate PSA levels (normal level is 4.0 ng/mL), leading to an unacceptable number of false positives.
Those false positives often lead to unnecessary treatment, erectile dysfunction, incontinence, and a ton of mental anguish.
Yet a recent survey found that an estimated 17 million men age 50 or older, without a history of prostate cancer or other prostate problems, still are being screened every year using unreliable test, even though the U.S. Preventative Services Task Force recommended in 2011 that it be dropped.
The American Urological Association guidelines suggest:
-No PSA screening for men under age 40
-No PSA screening for 40- to 54-year-olds with average risk for prostate cancer
-Shared decision-making with doctor for men 55 to 69
-No routine PSA screening for men over 70
A diagnosis of prostate cancer should be based on family history and a doctor's physical exam, including a digital rectal exam.
Meanwhile, a better screening test is needed, and may be on the way. Currently, a certain diagnosis can be made only via biopsy.
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