Screening for Prostate Cancer in Primary Care

Ingrid J. Hall, PhD, MPH

Epidemiologist and Team Lead
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Atlanta, GA

Prostate cancer is the most common cancer detected in men, with an estimated 200,000 new cases reported in the United States in 2010. Prior to use of the prostate-specific antigen (PSA) test, diagnosis usually occurred after the cancer had progressed to cause symptoms such as painful urination and blood in the urine or semen. An elevated PSA test triggering histological assessment permits diagnosis while the disease is asymptomatic. Earlier diagnosis has, in turn, led to patients with early-stage disease being treated with radiation or surgical prostatectomy, despite lack of evidence that the cancer would necessarily progress to clinical significance. Recommendations for routine population-based prostate cancer screening, therefore, remain vague. Instead, men ≥50 years of age are encouraged to speak with their physician about the appropriateness of the PSA test for their individual situations. Dr Hall discusses results and key findings from her most recent study, looking at factors affecting the likelihood that primary care physicians discussed and encouraged prostate cancer screening with their patients, knowledge of the current guidelines, and how they could be used to improve screening in the primary care setting.

References

Hall IJ, Taylor YJ, Ross LE, Richardson LC, Richards TB, Rim SH. Discussions about prostate cancer screening between U.S. primary care physicians and their patients. J Gen Intern Med. 2011 Mar 18. [Epub ahead of print] PubMed
National Cancer Institute. Prostate Cancer Home Page. Available at http://www.cancer.gov/cancertopics/types/prostate
Sajid S, Mohile SG, Szmulewitz R, Posadas E, Dale W. Individualized decision-making for older men with prostate cancer: balancing cancer control with treatment consequences across the clinical spectrum. Semin Oncol. 2011;38:309-25. PubMed
Ilic D, O'Connor D, Green S, Wilt TJ. Screening for prostate cancer: an updated Cochrane systematic review. BJU Int. 2011;107:882-91. PubMed

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