The US Preventive Services Task Force (USPSTF) has recommended that screening for prostate cancer should stop in men over the age of 75 who have a life expectancy of less than 10 years. As expected there has been an outcry from the American Cancer Society who argue that past recommendations advocated a cessation of prostate cancer screening in anyone with a life expectancy of less than 10 years – regardless of age.

So why the change? Well, the USPSTF feels that the harm of screening outweigh the benefits. That is, erectile dysfunction, loss of bladder/bowel control and death can result from treatment that may not affect overall longevity.

Many of our screening guidelines hinge on age: there are recommendations based on age for vaccinations, mammograms, PAP tests, colonoscopy but like all recommendations, these are simply guidelines. Are many men active well past the age of 75 – yes. Should they continue to be screened? Of course. 

We decide in some cases to screen earlier in women who have a strong family history of breast cancer or in men or women with a strong family history of colon cancer. On the other hand, if someone has significant co-morbidities and wouldn’t survive the treatment or who for whatever reasons, refuse treatment, then screening would be inappropriate.  

The most important thing is to talk with your health provider. All decisions to screen, or adopt a “watchful waiting period” or treat should be made in consultation with your specialist. Guidelines are not rules.

Be sure to watch the video on this site entitled, “Prostate Cancer: When is ‘Watchful Waiting’ a Good Option?”

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