Prostate Cancer Screening: The Scientific View

By Otis W. Brawley, MD, FACP

Actor Ben Stiller revealed Tuesday that he had been diagnosed with prostate cancer two years ago and he discussed his experience in an article published on Medium.  Stiller’s prostate cancer story is not unusual. There are countless instances where men with no symptoms, no known family history, no other risk factors, undergo screening for prostate cancer, who have prostate cancer detected, treated, and are left better off. And it would be hard to convince these men that screening did not save their lives.

But we now know that the majority of men with prostate cancer will not die of their disease, whether they receive aggressive treatment, are watched carefully, or even if it was never diagnosed.

The harsh truth is that even under the best conditions, with careful screening, some men will still die of prostate cancer.

This is why no major health group recommends all men be screened. The PSA test can be useful, but it is not perfect, not by a longshot.

Mr. Stiller admits he is “not offering a scientific point of view here, just a personal one…” So what is the scientific point of view? Twelve professional organizations in the United States and Europe have looked at the scientific data. Six of those, including the American Cancer Society, suggest men of average risk be informed of the known risks and benefits of screening and make a decision about screening. Six recommend that men not get screened. Most groups that recommend informed decision making suggest men of average risk consider screening starting at age 50.

This post was originally published in response to Ben Stiller’s post on Medium.

 Dr. Brawley is chief medical and scientific officer for the American Cancer Society.

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