To screen or not to screen? When it comes to cancer, doctors say early detection is the best defense. But the picture is a little fuzzier when it comes to prostate cancer, which in many cases progresses slowly and may not require aggressive treatment. In March, a 10-year National Cancer Institute study involving more than 76,000 men seemed to make the case for watchful waiting. About half of the study volunteers were randomly assigned to the screening group, getting either a manual exam or a prostate-specific antigen test each year; the latter test measures blood levels of a protein associated with prostate cancer. The other study participants received no screening guidance and were left to decide on their own whether they would get a yearly test. At the seven-year mark, 50 men had died from prostate cancer in the screening group, and 44 had died in the usual-care group. In other words, screening and early detection did not lower the death rate from prostate cancer.
Based on this and other studies, the U.S. Preventive Services Task Force said there was insufficient evidence to assess the balance of benefits and harms of prostate-cancer screening in men younger than age 75. The task force recommended against prostate-cancer screening in men 75 and older.