When should prostate cancer screening be discontinued?

Updated: Jan 14, 2019
  • Author: Lanna Cheuck, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

In a 2010 study, Tang et al concluded that in the 75- to 80-year age group, discontinuation of PSA screening may be safe in African-American men with an initial PSA measurement of less than 6.0 ng/mL and in Caucasian men with an initial PSA measurement of less than 3.0 ng/mL. The investigators found that men in these groups are unlikely to develop high-risk prostate cancer or to die from prostate cancer. [16]

The NCCN advises that, although very few men over the age of 75 benefit from PSA testing, a clinically significant number may develop aggressive cancers that pose significant risk if they are not detected before they produce symptoms. For that reason, testing may be considered in select patients who are very healthy and have little or no comorbidity, but clinicians may consider raising the threshold for biopsy to a PSA level of >4 ng/mL. [3]

As noted above, the USPSTF and ESMO recommend against PSA-based screening for prostate cancer for men aged 70 years and older. [5, 4]


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