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Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in men without signs or symptoms. [ 1 ] [ 2 ] When abnormal prostate tissue or cancer is found early, it may be easier to treat and cure, but it is unclear if early detection reduces mortality rates.
For men over 64 with prostate cancer limited to the pelvis, using fewer, larger doses of radiation (hypofractionation) results in similar overall survival rates. [28] The risk of dying from prostate cancer or having acute bladder side effects may be similar to that of longer radiation treatment. [ 28 ]
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Prostate cancer is the most diagnosed cancer in men in over half of the world's countries, and the leading cause of cancer death in men in around a quarter of countries. [91] Prostate cancer is rare in those under 40 years old, [92] and most cases occur in those over 60 years, [2] with the average person diagnosed at 67. [93]
When PSA screening began in the 1980s, cases of prostate cancer rose by 26% between 1986-2005, with the most affected age group being men under the age of 50. [37] Prostate cancer is a heterogeneous disease, and the cancer will grow aggressively in approximately 1 in 3 cases. Therefore there is a risk of overdiagnosing and overtreating, this ...
Additionally many prostate cancers detected by screening develop so slowly that they would not cause problems during a man's lifetime, making the complications due to treatment unnecessary. The most frequent side effect of the procedure is blood in the urine (31%). [2] Other side effects may include infection (0.9%) and death (0.2%). [2]
In men aged 55–69 who have been counseled on the known harms and potential benefits of prostate cancer screening, the U.S. Preventive Service Task Force May 2018 statement states, "The use of digital rectal examination as a screening modality is not recommended because there is a lack of evidence on the benefits."
In a separate study of men from the pre prostate cancer screening era managed with watchful waiting (56% over age 70 years), progression to distant metastasis or prostate cancer death was 13.9% and 12.3%, respectively for Gleason score 6 or below, but considerably higher at 18.2 and 22.7%, 30% and 20%, 44.4% and 55.6% for Gleason 3+4, 4+3, and ...