Elderly and Prostate Cancer Screening
PURPOSE: To discuss the issue of screening for prostate cancer in elderly individuals. The impact of life expectancy on the choice of treatment in both patients and health care providers has been investigated as well. MATERIALS AND METHODS: We identified studies published from 1990 onwards by search...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences
2011-06-01
|
| Series: | Urology Journal |
| Subjects: | |
| Online Access: | http://www.urologyjournal.org/index.php/uj/article/view/1015/541 |
| _version_ | 1818110177131364352 |
|---|---|
| author | Konstantinos N Stamatiou |
| author_facet | Konstantinos N Stamatiou |
| author_sort | Konstantinos N Stamatiou |
| collection | DOAJ |
| description | PURPOSE: To discuss the issue of screening for prostate cancer in elderly individuals. The impact of life expectancy on the choice of treatment in both patients and health care providers has been investigated as well. MATERIALS AND METHODS: We identified studies published from 1990 onwards by searching the MEDLINE database of the National Library of Medicine. Initial search terms were “localized prostate cancer” and “early stage prostate cancer” combined with “elderly patients, life expectancy, palliative, curative, quality of life, watchful waiting, radical prostatectomy, brachytherapy, and external beam radiotherapy”. RESULTS: Despite the decrease in prostate carcinoma-specific mortality, the use of prostate-specific antigen (PSA) has been shown to increase the prostate cancer detection rate with a shift to detection at earlier and less invasive pathological stages, overriding concerns about over-diagnosis and overtreating. However, PSA screening is mainly offered to younger individuals, and older patients are more likely to have progressive disease and high-risk prostate cancer at diagnosis. Given that PSA screening diagnoses mainly curable, early prostate cancer, screening decision could be offered to otherwise healthy elderly patients who are likely to benefit from aggressive treatment. CONCLUSION: Prostate-specific antigen screening is not officially recommended and most scientific associations promote shared decision making. While PSA screening decision is currently based on physician’s judgment, it is clear that a strict age cut-off of 75 years reduces over-screening, but also prohibits screening in healthy older men with a long life expectancy. |
| first_indexed | 2024-12-11T02:43:00Z |
| format | Article |
| id | doaj.art-d2fc01d426a6491ea7f066fdeb9c87bd |
| institution | Directory Open Access Journal |
| issn | 1735-1308 1735-546X |
| language | English |
| last_indexed | 2024-12-11T02:43:00Z |
| publishDate | 2011-06-01 |
| publisher | Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Urology Journal |
| spelling | doaj.art-d2fc01d426a6491ea7f066fdeb9c87bd2022-12-22T01:23:31ZengUrology and Nephrology Research Center, Shahid Beheshti University of Medical SciencesUrology Journal1735-13081735-546X2011-06-01828387Elderly and Prostate Cancer ScreeningKonstantinos N StamatiouPURPOSE: To discuss the issue of screening for prostate cancer in elderly individuals. The impact of life expectancy on the choice of treatment in both patients and health care providers has been investigated as well. MATERIALS AND METHODS: We identified studies published from 1990 onwards by searching the MEDLINE database of the National Library of Medicine. Initial search terms were “localized prostate cancer” and “early stage prostate cancer” combined with “elderly patients, life expectancy, palliative, curative, quality of life, watchful waiting, radical prostatectomy, brachytherapy, and external beam radiotherapy”. RESULTS: Despite the decrease in prostate carcinoma-specific mortality, the use of prostate-specific antigen (PSA) has been shown to increase the prostate cancer detection rate with a shift to detection at earlier and less invasive pathological stages, overriding concerns about over-diagnosis and overtreating. However, PSA screening is mainly offered to younger individuals, and older patients are more likely to have progressive disease and high-risk prostate cancer at diagnosis. Given that PSA screening diagnoses mainly curable, early prostate cancer, screening decision could be offered to otherwise healthy elderly patients who are likely to benefit from aggressive treatment. CONCLUSION: Prostate-specific antigen screening is not officially recommended and most scientific associations promote shared decision making. While PSA screening decision is currently based on physician’s judgment, it is clear that a strict age cut-off of 75 years reduces over-screening, but also prohibits screening in healthy older men with a long life expectancy.http://www.urologyjournal.org/index.php/uj/article/view/1015/541prostate canceragedprostate-specific antigenlife expectancy |
| spellingShingle | Konstantinos N Stamatiou Elderly and Prostate Cancer Screening Urology Journal prostate cancer aged prostate-specific antigen life expectancy |
| title | Elderly and Prostate Cancer Screening |
| title_full | Elderly and Prostate Cancer Screening |
| title_fullStr | Elderly and Prostate Cancer Screening |
| title_full_unstemmed | Elderly and Prostate Cancer Screening |
| title_short | Elderly and Prostate Cancer Screening |
| title_sort | elderly and prostate cancer screening |
| topic | prostate cancer aged prostate-specific antigen life expectancy |
| url | http://www.urologyjournal.org/index.php/uj/article/view/1015/541 |
| work_keys_str_mv | AT konstantinosnstamatiou elderlyandprostatecancerscreening |