World-renowned experts have suggested updated guidelines for prostate cancer screening, just as disgraced football player OJ Simpson died after a battle with the disease.
Scientists in the United States and Europe have proposed reducing the frequency of screening for some men by two to five years.
Current guidelines are not as well defined as those for other cancers, such as breast or colon cancer, and most state that the patient should consult with their doctor.
The American Urological Association suggests offering screening every two to four years.
These include an internal examination of the prostate and a blood test to measure prostate-specific antigen (PSA) protein levels. Elevated levels may indicate a problem with the organ.
Prostate cancer is one of the most common forms of the disease, affecting 300,000 American men each year. It is more common in people over 50 years of age.
But who should receive what and how often is unclear and can vary widely between ages, races and men with family history.
Additionally, the PSA test can give false positives, leading people to undergo additional, unnecessary testing and treatment.
At the European Association of Urology Congress in Paris last week, urologists said some men may now only need a blood test every five years.
Urologists at the conference proposed new guidelines based on PSA levels detected in preliminary tests among men ages 45 to 50.
The men were placed into different risk categories based on PSA levels from an initial blood test: less than 1.5 ng/ml was low; 1.5-3 ng/ml was intermediate; and 3 ng/ml or more was high risk.
OJ Simpson announced in February that he had been diagnosed with prostate cancer. The disgraced athlete died of the disease in April.
Low-risk men should have a PSA test every five years in the future. People at medium risk should be screened every two years, and people considered high risk will be prescribed additional tests and treatments, such as an MRI and prostate biopsy.
The findings were based on the PROBASE test of 12,500 men between 45 and 50 years old.
Other results showed that almost none of the men in the low-risk group developed prostate cancer at the five-year follow-up, which the researchers said indicated that one test every five years is sufficient.
They also said that increasing the low-risk threshold from 1.0 ng/ml to 1.5 ng/ml would significantly reduce the number of people who need to undergo additional screening.
Dr. Peter Albers, co-author of the PROBASE study, said Healthline’s new recommendations could “greatly improve the harms of screening by increasing the negative predictive value of PSA.”
A seperation study published in the journal JAMA this month found that PSA testing alone reduced prostate cancer mortality by 0.09 percent among a study population of 400,000 men.
The study’s lead author, Dr. Richard Martin, told Healthline: “Only a few fewer men who were invited for a PSA test died from prostate cancer.” There wasn’t much difference between the two groups.
“There is an urgent need to find ways to detect cancers that need treatment early and avoid the diagnosis of low-risk cancers.”
Results from another JAMA study Also published this month, they suggest that using biomarker panels in addition to PSA testing could provide greater benefits in terms of screening while reducing unnecessary treatment.
In an accompanying editorial, Dr. Jeffrey Tosoian, a professor of urology at Vanderbilt University, said the findings suggest that using additional tools ensures that men at highest risk for prostate cancer receive additional treatment, while those with lower risk of not undergoing unnecessary biopsies.
Prostate cancer is the second most common form of cancer in men, only behind skin cancer. The disease forms from cancer cells in the prostate, a walnut-sized organ found only in men.
Located between the base of the penis and the rectum, the prostate produces fluid that mixes with sperm to help them travel and survive.
Experts estimate the disease will affect 300,000 American men this year and kill more than 35,000, most of whom are over 65 years old.
The American Cancer Society (ACS) says rates are increasing about three percent each year, which it attributes to an increasingly older population and inconsistent screening guidelines.
Additionally, health care providers warn that the disease can be difficult to detect, as it often causes no symptoms at first. The signs often reflect those of an enlarged prostate, which tends to affect older men, such as King Charles, who underwent treatment for an enlarged prostate earlier this year.
This could cause it to spread rapidly to the bones and organs such as the lymph nodes, lungs, liver, and brain.
Prostate cancer usually causes no symptoms in its early stages, but symptoms may include frequent urination, blood in urine or semen, difficulty urinating, a weak urine stream, and pain in the testicles.
Doctors aren’t completely sure what causes prostate cancer, although they have identified some risk factors, such as older age, family history, obesity, smoking, sexually transmitted infections, and being African American.
The five-year survival rate for the disease, which often responds well to treatment, is 99 percent if the cancer has not spread outside the organ.
If so, the survival rate drops to 34 percent in later stages, when it can spread to the bones.
Treatment of the disease includes a prostatectomy, a minimally invasive surgery to remove all or part of the prostate gland.