Prostate cancer screening-when to start and how to screen? Journal Article


Authors: Kohestani, K.; Chilov, M.; Carlsson, S. V.
Article Title: Prostate cancer screening-when to start and how to screen?
Abstract: Prostate-specific antigen (PSA) screening reduces prostate cancer (PCa) mortality; however such screening may lead to harm in terms of overdiagnosis and overtreatment. Therefore, upfront shared decision making involving a discussion about pros and cons between a physician and a patient is crucial. Total PSA remains the most commonly used screening tool and is a strong predictor of future life-threatening PCa. Currently there is no strong consensus on the age at which to start PSA screening. Most guidelines recommend PSA screening to start no later than at age 55 and involve well-informed men in good health and a life expectancy of at least 10-15 years. Some suggest to start screening in early midlife for men with familial predisposition and men of African- American descent. Others suggest starting conversations at age 45 for all men. Re-screening intervals can be risk-stratified as guided by the man's age, general health and PSA-value; longer intervals for those at lower risk and shorter intervals for those at higher risk. Overdiagnosis and unnecessary biopsies can be reduced using reflex tests. Magnetic resonance imaging in the pre-diagnostic setting holds promise in pilot studies and large-scale prospective studies are ongoing. © Translational Andrology and Urology.
Keywords: screening; baseline prostate-specific antigen; prostate cancer (pca)
Journal Title: Translational Andrology and Urology
Volume: 7
Issue: 1
ISSN: 2223-4683
Publisher: AME Publishing Company  
Date Published: 2018-02-01
Start Page: 34
End Page: 45
Language: English
DOI: 10.21037/tau.2017.12.25
PROVIDER: scopus
PMCID: PMC5861291
PUBMED: 29594018
DOI/URL:
Notes: Review -- Export Date: 1 February 2018 -- Source: Scopus
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MSK Authors
  1. Sigrid Viktoria Carlsson
    127 Carlsson
  2. Marina Chilov
    4 Chilov