For years, men were told as they age that going in for routine prostate cancer screening that included a simple blood test was the key to getting ahead of this potentially fatal condition. Now, many doctors are instead recommending most men skip the blood draw entirely unless certain mitigating factors are present. That all adds up to the potential for men – and even some doctors – to be a bit confused.

The standard recommendations in regard to the blood test – the prostate-specific antigen test – have changed. The U.S. Preventative Services Task Force now recommends the PSA only be used to gauge standing during prostate cancer treatments and if men are at especially high risk for screening purposes. The standard test was taken off the table as a routine screening tool because it can produce a fair amount of false positives. The false positives, in turn, promoted unnecessary prostate biopsies, which are invasive and can lead to undesirable consequences.

With an estimated 180,000 American men likely to be diagnosed with prostate cancer this year, the changes in screening recommendations have left some men and their doctors a little perplexed. No widespread screening tool was introduced to replace the PSA when it was taken off the table. Instead, men still undergo routine digital rectal exams during physicals and other tests, including the PSA, may be used if risk is especially high or suspicion that prostate cancer is present happen to be. While these alternatives may detect some cancer cases readily, some physicians worry that many other men will be left with more aggressive forms of the disease that will go undetected without the use of the PSA to set off early warning bells.

Screening recommendation changes or not, there are things men and their doctors can do to help ensure prostate cancer is caught early should it develop. One of the first things men should do is to have an open, frank discussion about prostate cancer with their healthcare providers around the age of 50 or so. Men should understand their personal risks for the disease, so factors that can be addressed are. In addition, men who do find themselves at higher risk may want to undergo PSA testing anyway. The test is just out of the routine screen loop, but it’s not off the table entirely. Some researchers, in fact, have found that the PSA remains very helpful in early screening if its results are vetted with a follow-up test before additional action, such as a biopsy, is taken.

Prostate cancer screening recommendations have changed. The prevalence of this disease, however, has not. Men who are concerned about this condition should get sound advice from their healthcare providers.

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