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Genetics of Prostate Cancer (PDQ®)

  • Posted: 11/20/2003
  • Updated: 07/18/2014

Table 12. Summary of Prostate Cancer Screening Recommendations for High-Risk Men

Screening Recommendation Source Population Test Age Screening Initiated Frequency Comments 
United States Preventive Services Task Force (2012) [7]No specific recommendation for high-risk populations (defined as black men and men with a prostate cancer family history).
American College of Physicians (2013) [8]African American men and men with first-degree relative diagnosed with prostate cancer, especially <65 yPSA≥45 yNo clear evidence to establish screening frequencyCounseling includes information about the uncertainties, risks, and potential benefits associated with prostate cancer screening.
No clear evidence to perform PSA test more frequently than every 4 y
Men with family history of multiple family members with prostate cancer diagnosed <65 yPSA≥40 y
PSA level >2.5 µg/L may warrant annual screening
American Urological Association (2013) [9]African American men and men with a strong prostate cancer family historyPSA>40 to <55 yIndividualized based on personal preferences and informed discussion regarding the uncertainty of benefit and associated harms.
American Cancer Society (2014) [10]African American men and/or men with a father or brother with prostate cancer diagnosed <65 yPSA with or without DREa≥45 yFrequency depends on PSA levelCounseling consists of a review of the benefits and limitations of testing so that a clinician-assisted, informed decision about testing can be made.
Men with multiple family members with prostate cancer diagnosed <65 yPSA with or without DREa≥40 yFrequency depends on PSA level
NCCN (2014) [11]African American men and men with family history of prostate cancerPSA with or without DREbBaseline age 45–49 yEvery 1–2 y if DRE within normal limits AND PSA level >1 ng/mLCounseling includes:
Repeat testing at age 50 y if DRE within normal limits AND PSA level ≤1 ng/mL– Screening purpose is to detect aggressive prostate cancer.
50–70 yEvery 1–2 y if DRE within normal limits AND PSA level <3 ng/mL– Screening usually identifies low risk cancers that can be managed through close surveillance.
>70 ycEvery 1–2 y if DRE within normal limits AND PSA level <3 ng/mL
NCCN (2014) [11,12]Men with BRCA1 deleterious mutationPSA with or without DREbConsider screening starting at age ≥40 yEvery 1–2 y
Men with BRCA2 deleterious mutationPSA with or without DREb≥40 yEvery 1–2 y

DRE = digital rectal exam; NCCN = National Comprehensive Cancer Network; PSA = prostate-specific antigen.
aDRE is recommended in addition to PSA test for men with hypogonadism.
bDRE not performed as a stand-alone screening exam. Performed in men with an elevated PSA and as a baseline exam in men with PSA levels within normal limits.
cScreening performed with caution and limited to men in good health with little or no comorbidities.

References

  1. Moyer VA; U.S. Preventive Services Task Force: Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 157 (2): 120-34, 2012.  [PUBMED Abstract]

  2. Qaseem A, Barry MJ, Denberg TD, et al.: Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med 158 (10): 761-9, 2013.  [PUBMED Abstract]

  3. Carter HB, Albertsen PC, Barry MJ, et al.: Early detection of prostate cancer: AUA Guideline. J Urol 190 (2): 419-26, 2013.  [PUBMED Abstract]

  4. Smith RA, Manassaram-Baptiste D, Brooks D, et al.: Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 64 (1): 30-51, 2014 Jan-Feb.  [PUBMED Abstract]

  5. National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer Early Detection. Version 1.2014. Rockledge, PA : National Comprehensive Cancer Network, 2014. Available online with free subscription. Last accessed June 17, 2014. 

  6. National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology: Genetic/Familial High-Risk Assessment: Breast and Ovarian. Version 1.2014. Rockledge, PA: National Comprehensive Cancer Network, 2014. Available online with free registration. Last accessed June 17, 2014.