Should prostate cancer screening stop after the age of 75?

The USPSTF recently advised against screening men older than age 75 for prostate cancer.

Is that recommendation sound? The NEJM has a nice perspective piece detailing the reasons why.

Some interesting points here.

First, efficacy for treatment in men aged 75 or older is questionable at best, as “18 radical prostatectomies would have to be performed to prevent a single death from prostate cancer over a 12-year period.” Furthermore, this level of effectiveness appears to be “confined to men 65 years of age or younger.”

Also, there are risks of routinely monitoring the PSA in an older population. PSA levels are age-dependent, meaning that men may have levels above the 4.0 ng per liter threshold without having disease. Prostate biopsies and subsequent procedures also have inherent risks, which again are age related, rising after the age of 75.

I agree with the USPSTF’s recommendation that the risks of prostate cancer screening outweigh the benefits in older men. It’s important for patients to understand why.

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