Guidelines on prostate screening changed

Officials say routine screening is not necessary for men 40-54 years old

 UPDATED 7:06 PM HST May 18, 2013
HONOLULU -

Second only to skin cancer, prostate cancer is the most common cancer in American men.

In a major shift, the American Urological Association has narrowed its recommendations of who should be screened for prostate cancer, saying testing should be done primarily in men aged 55 to 69.

But for men in Hawaii, there are other factors to consider before holding off on getting screened for prostate cancer.

The American Cancer Society estimates more than 238,000 new cases of prostate cancer will be diagnosed this year.

But in a major shift earlier this month, the American Urological Association guidelines on prostate screening were narrowed: the AUA now saying routine screening is not necessary for men 40 to 54 years old and screening not recommended for men 70 and older.  Local doctors are saying, hold on.

“We should actually suggest that all men starting at age 40 have their first PSA. When they’re finding the PSA less than one, they probably don’t need to be checked until 50 or 55. After that, it’s really if they have a risk factor,” said Straub urologist, Dr. Stephen Chinn.

PSA stands for prostate-specific antigen, the test that identifies prostate cancer risk.  The reason for tightening the guidelines was to avoid unnecessary cancer treatment, but doctors here said men in Hawaii tend to live longer.

And factors such as radiation and Agent Orange exposure increase the risk in men.  Doctors said one of the keys to identify whether you’re at risk for prostate cancer is to simply talk to your family.

“Very commonly, we have people come in and say, ‘Well, Dad had a prostate problem, but I don’t know if it was cancer or not.’ Well, then go back to his physician and find out,” said Chinn.

“Virtually every health condition and disease that we’re dealing with has some basis in genetics. So people should find out about the family history of breast cancer or the history of colorectal cancers”

The guidelines do say those men at higher-than-average risk, such as those who have a family history of prostate cancer or African American men should discuss with their physicians the benefits and harms of starting screening before the age of 55.

Something doctors here agree upon.  Better testing is now coming out that can identify the more aggressive form of prostate cancer.

Although a serious disease, the American Cancer Society said most men diagnosed with prostate cancer do not die from it.

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