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To Screen or Not to Screen: Detecting Prostate Cancer

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With the widespread use of prostate-specific antigen (PSA) testing to identify men at increased risk of prostate cancer, more individuals have been diagnosed with prostate cancer than in the period before PSA testing was widely available (pre-1992). Cancers diagnosed through PSA testing are often early stage or less advanced cancers. According to data from the National Cancer Institute, more than 90 percent of all prostate cancers are now diagnosed at a less advanced stage and men are surviving longer after diagnosis and treatment.

Once prostate cancer is diagnosed, you and your doctor must go through a process of risk assessment, estimating the likelihood that your cancer has or may spread outside the prostate and assessing your risk of disease recurrence after treatment. This assessment combined with characteristics of your overall health will allow your doctor to advise which treatment option will benefit you the most. Your doctor will use factors such as your Gleason score, PSA level, tumor stage and the number of tumor samples (called cores) taken by biopsy that are positive for cancer.

A variety of factors and tools can be used to assess your chances of surviving prostate cancer and the effectiveness of treatment in halting the progression of the disease. Among the tools your doctor may use are Internet-based calculators or nomograms, published tables and biological markers that may help predict outcomes.

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