By Dr. Peter Kadile
Preventive medicine is something that I practice almost every day. The guidelines for screening for cancer can change and are often confusing for everyone. The United States Preventive Services Task Force (USPSTF) is a panel of experts in primary care and preventive medicine that reviews the evidence and develops recommendations for clinical preventive services. I’d like to mention some of the screening guidelines that they currently recommend for prostate cancer, breast cancer and colon cancer.
Prostate Cancer Screening
PSA or prostate specific antigen is a blood test that has been used in the past to screen for prostate cancer. The U.S. Preventive Services Task Force (USPSTF) recommends against prostate-specific antigen (PSA)-based screening for prostate cancer. The benefits of screening with PSA do not outweigh the potential harms. The USPSTF does not make any recommendations on the use of the digital rectal exam (DRE) in the detection of prostate cancer. The USPSTF recommendations do not mean I won’t perform a PSA or DRE on a male patient but that screening considerations can be individualized based on a patient’s family history of prostate cancer and if the patient is having any symptoms. In general, asymptomatic men do not need to have a PSA checked.
Breast Cancer Screening
Mammograms have been used to screen for any abnormal masses in the breast. The USPSTF recommends screening mammography every two years for women age 50-74 years. Screening prior to age 50 is an individual one and consideration of abnormal physical findings and/or family history of breast cancer is important. The USPSTF states that there isn’t enough evidence for the benefit or harm for mammograms after the age of 75.
Colon Cancer Screening
The United States Preventive Services Task Force recommends screening for colon cancer starting at age 50 and continuing until age 75. The USPTF found convincing evidence that screening for colon cancer between the ages of 50-75 reduces the rate of death from colon cancer. A non-invasive method for screening for colon cancer is checking a patient’s stool for blood. The invasive method would be a colonoscopy. Family history of colon cancer and a person’s symptoms would guide which test should be performed.