Age is certainly one of them, so most studies show that six out of ten men with prostate cancer are aged 65 or older. Family history is certainly significant. So a man with a father or brother, namely a first-degree male relative, has about double the risk of prostate cancer compared to the general population. African-American black men are more likely to develop prostate cancer and even aggressive prostate cancer, and so those high-risk patient populations really weren’t rigorous screening.
Prostate screening age
The screening for prostate cancer is variable. There are some recommendations to start screening for prostate cancer at the age of 40, typically for African-American males. For males who have a strong history of prostate cancer and their families, the current recommendation would be that an initial screening take place at the age of 40. If that screening was normal, then repeat it at 45 and if that is normal, then go on to age 50. The general population’s recommendation for screening would essentially be to start at the age of 50. If there were no risk factors, no high risk of family history of prostate cancer, then we would start at age 50.
African American prostate cancer
African-American males tend to have a higher risk for prostate cancer. There is certainly an increased risk for prostate cancer in families where there is a primary relative being a father or a brother. Prostate cancer is the most common form of cancer in men. It’s the most commonly diagnosed cancer in men. We started talking about men over the age of 50. The detection rate for prostate cancer has been relatively stable over the last several decades, with prostate cancer screening traditionally over about the last 20 years.
Prostate cancer screening involves a blood test called PSA. PSA stands for prostate specific antigen. It’s a protein that’s produced by the prostate gland that makes it into the bloodstream. If the PSA test is elevated, it tends to be an indication that you are at a higher risk of having prostate cancer. It does not actually diagnose prostate cancer. It’s a screening test to tell us which patients may or may not have a higher risk of having prostate cancer. There is another screening for a portion of the screening, which is the examination of the prostate. Examination of the prostate before the advent of PSA testing was the most common way to diagnose prostate cancer.
Typically, when prostate cancer is diagnosed by being able to examine the prostate digitally, the prostate cancer at that point in time is typically a little bit larger if it’s large enough to be felt, so in the PSA era, the primary mode of detecting prostate cancer has been an elevated PSA test. One of the things that I talk to patients about routinely is that PSA testing is only one tool that we use, and prostate cancer is only one of the disease processes that can happen in the prostate. It’s actually much more common for men to have benign disease of the prostate than it is to have cancerous disease of the prostate. The benign disease of the prostate typically has symptoms, whereas prostate cancer typically does not have very many symptoms. The enlarged prostate oftentimes is just a benign process where the prostate grows large and then constricts, It’s to manage the more benign diseases.