Prostate cancer is the most commonly diagnosed cancer in men in the United States. Prostate cancer can present as a very slow growing cancer, and in many cases, advanced surveillance rather than aggressive treatment is recommended. Prostate cancer can also be an aggressive cancer that requires treatment.
Screening for prostate cancer is performed by a blood test called PSA (prostate specific antigen). The guidelines for prostate cancer screening; i.e. when to begin screening and how to screen, have changed over the past few years. Less aggressive prostate cancers do not require the extensive treatment required by more aggressive prostate cancers that can result in incontinence or impotence. The current recommendation is for men to begin PSA screening at the age of 45. The PSA level will determine whether the test should be repeated in 1-2 or 2-4 years. Testing is continued until the age of 75 or possibly later, depending on the health of the individual. African American men are at higher risk for developing prostate cancer and develop prostate cancer at an earlier age in comparison to Caucasian-American men. African American men may choose to begin screening at an earlier age.
The most common risk factors for prostate cancer are age, ethnicity, and inherited genetic variants. Specific DNA changes in 16 different genes have been identified to be associated with an increased risk of prostate cancer. Many of these gene mutations are associated with other types of cancers. Men with a family history of prostate, breast, ovarian, colon, uterine, and stomach cancers in first and second-degree relatives (bloodline from both sides of the family) would be wise to have genetic counseling to determine whether they meet the guidelines for genetic testing.
With the strong genetic component in prostate cancer, knowing if you have a genetic predisposition to prostate cancer can be invaluable in deciding whether to have PSA screening and when to begin screening. Knowledge of their increased risk allows men and their physicians to determine a proactive plan of action for early prostate cancer diagnosis.
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