They should discuss with their doctor the potential benefits and harm which can result from both the testing for and treatment of prostate cancer. Based on this discussion, patients should decide themselves whether or not they want to be screened. If the decision is made to perform screening, in blacks and in men with a first degree relative with prostate cancer, screening should begin at age 40. Otherwise, screening should begin at age 50. Prostate cancer is now the most commonly diagnosed cancer in men in the United States.
Prostate cancer is second only to lung cancer in causing death from cancer.
It will be another 10 years before we have enough data to determine whether the current treatment of asymptomatic cancers will either lengthen or improve the quality of men's lives. In patients with symptomatic prostate cancer, the improvement after treatment diminishes with age. Men in their '50s gained an extra 3 years of life. Men in their '60s average only 1.5 extra years of life and men over 70 years old gain at best only several weeks of extra life. It has been found that for every five patients with an abnormal DRE who go on to prostate needle biopsy, only one will be found to actually have prostate cancer.