So for physicians treating prostate cancer, "our message is that younger men with high-grade cancers do very poorly, and when you find one, be aware that it should be treated aggressively and with experimental methods if necessary," Lin said.
PSA screening is now a major issue, with a controversy triggered by two recent reports indicating that routine screening is relatively ineffective at reducing prostate cancer deaths.
Screening recommendations by major organizations vary widely, Brawley noted, with some groups, including the American Association of Family Physicians, flatly against such programs. The American Cancer Society guidelines, which now are under review, call for a physician to discuss, but not necessarily offer, a PSA test to men with normal risk at age 50, and to high-risk men at 45.
Men at higher risk are those with a father or brother who has had the disease, and black men, who are more likely to develop prostate cancer for unknown reasons, Brawley said.
The new study supports the recommendation for earlier screening, Freedland said. "These are men that have 30 to 40 years to live, and will have the most benefit from screening," he said.
You can learn all about prostate cancer from the U.S. National Cancer Institute.
SOURCES: Daniel W. Lin, M.D., chief, urologic oncology, University of Washington, Seattle; Otis W. Brawley, M.D., chief medical offic
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