Dear OncoLink "Ask the Experts,"
Hi Dr. Wein, please let me know what is your perception of an ideal prostate-screening program, what barriers are usually encountered while providing cancer screening?
Alan J. Wein, MD, Professor and chair of the Division of Urology at the University of Pennsylvania School of Medicine and Chief of Urology at the Hospital of the University of Pennsylvania, responds:
Prostate cancer is rarely seen in men younger than 50 years old. The chance of developing prostate cancer increases, as men get older. So, if you are over 50, you should have a PSA and a digital rectal exam yearly.
Black males are more likely to develop prostate cancer than white males. Black males are also more likely to die of prostate cancer than white males. So, if you are over 40 years old and African American, you should continue to have a PSA yearly.
Family history of prostate cancer is also a significant factor when screening. A man whose father, brother, or son has had prostate cancer has a higher-than-average risk of developing prostate cancer. So, if you are over 40 with a first-degree relative who had prostate cancer, you should continue to have a PSA and digital rectal exam yearly.
The barriers to this screening program are fear and lack of education. Most men are frightened of prostate cancer and the examination and shy away from this. Education that early diagnosis means better curability is lacking.