Viewpoint: expanding prostate cancer screening

William J Catalona ¹, Stacy Loeb , Misop Han

⁰Northwestern Feinberg School of Medicine, Department of Urology, Chicago, Illinois 60611, USA. wcatalona@nmff.org

Annals of Internal Medicine +

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March 22, 2006

View abstract on PubMed

Summary

Prostate cancer screening using prostate-specific antigen (PSA) is effective. Recommendations include starting screening at age 40 for average-risk men, continuing for select healthy men over 70, and lowering the biopsy threshold to 2.5 ng/mL.

Area Of Science

Urology
Oncology
Preventive Medicine

Background

Prostate cancer screening guidelines differ among professional organizations.
Controversy exists regarding the efficacy and optimal implementation of prostate cancer screening.
Recent evidence since 2000 supports the benefits of prostate-specific antigen (PSA) screening.

Purpose Of The Study

To address key issues in prostate cancer screening: biopsy criteria, initiation age, and cessation age.
To evaluate the evidence for PSA screening efficacy.
To provide updated recommendations for prostate cancer screening protocols.

Main Methods

Review of scientific evidence published since 2000 concerning PSA screening efficacy.
Analysis of data to determine optimal screening ages and PSA thresholds.
Formulation of recommendations based on current evidence.

Main Results

Evidence supporting the efficacy of PSA screening is considered convincing.
Recommended starting age for average-risk men is 40 years.
Selected healthy men over 70 years should continue screening.
Recommended PSA threshold for biopsy consideration is lowered to 2.5 ng/mL.

Conclusions

PSA screening is effective for prostate cancer risk assessment.
Screening protocols should be individualized based on risk and health status.
Updated guidelines can improve prostate cancer detection and management.

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