Prostate Cancer Screening
Newborn Screening
The Thromboelastogram
Community-acquired MRSA
Diagnostic Utility of Skin Biopsy
Diagnosis of Sepsis
Osteoporosis in Men
Oral Anticoagulant Therapy
Patient with Allergy
Cytology
Role of Vancomycin
Estimated average glucose
Fungitell Option 2
Evolving role of Troponins
Aspirin Resistance
Tumor Markers
Sentinel Lymph Node Biopsy
Swine Influenza
Syphillis
Hereditary Haemochromatosis
Haematological Changes in HIV
Influence of HIV
Drug induced liver injury
Alcohol Abuse
HPV testing in woman
Intravenous immunoglobulins
Death certification
Breat Cancer Month
Therapeutic Plasma Exchange
Bedroom Zoonoses

Prostate Cancer Screening

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Dr Frank Kramer - MBChB (Pret) FFPath (SA)

PATHCHAT NO 1 - THE LATEST ON PROSTATE CANCER SCREENING

The goal of early detection of prostate cancer has been the identification of those with clinically significant cancer. The development of PSA testing in the 1990s has been the most important advance that has been made in detecting prostate cancer at an early stage.

 Recently, more sensitive and specific tests for screening for prostate cancer have been developed, which have improved the detection of both aggressive (faster growing) and non-aggressive (slow growing) prostate cancers. The natural history of prostate cancer is that it is progressive over time but over what period of time is uncertain. The challenge, therefore, is to identify the biology of the cancer, so that those cancers requiring treatment are detected early and treated effectively, which will significantly reduce the morbidity and mortality. Furthermore, unnecessary biopsies and over-treatment of cancers not requiring treatment, resulting in significantly reduced quality of life (e.g. urinary and erectile dysfunction) may be prevented.

Age of onset of screening

The age for starting PSA screening together with digita l recta l examination (DRE) has traditionally been 50 years of age. However, high-risk groups such as men with a family history of prostate cancer and black African population groups, may benefit from screening at an earlier age. Furthermore, autopsy reports have shown histologic evidence of prostate cancer in ± 25% of men in the 4th decade of life, and cases have been reported in men in their 30's.Therefore it would be reasonable to obta in a base line PSA measurement at age 40 to assess the risk for subsequent prostate cancer detection. Such a risk assessment may be useful in deciding on the appropriate surveillance strategy or whether a prostate biopsy should be performed. Current guidelines recommend that for men who choose to begin PSA screening, should do so at age 40.

 

Read the full article here.