Former President Joe Biden’s recent prostate cancer diagnosis is reigniting discussions about routine screenings for the disease, The Washington Post reported May 20.
Mr. Biden, 82, announced May 18 that he was diagnosed with an aggressive form of prostate cancer that has spread to his bones.
His diagnosis has renewed attention on prostate cancer screening recommendations, particularly for older men. Prostate cancer is the second-leading cause of cancer deaths among men, yet most screening guidelines advise against routine testing in older age groups.
The American Cancer Society does not recommend routine prostate cancer screening. The U.S. Preventive Services Task Force also advises against screening for men 70 and older, and it leaves the decision up to individual men ages 55-69. In contrast, the American Urological Association recommends starting screening starting at age 40 for high-risk men and every two to four years for people ages 50-69.
The main concern around routine screening is the risk of false-positive results, overdiagnosis and overtreatment, which can lead to complications such as incontinence or erectile dysfunction.
That said, many cases are low risk and unlikely to affect a man’s lifespan, according to the report. Some experts have argued that lower-grade diagnoses should no longer be labeled “cancer” at all, as the term can create anxiety and push patients toward aggressive, unnecessary treatment.
“For most cancer screenings, there is an age when we say, ‘no more screening,'” Michael Morris, MD, head of the prostate cancer section at Memorial Sloan Kettering Cancer Center in New York City, told the Post. “The majority of prostate cancers that are diagnosed are not the aggressive kind that we’ve been reading about [in the Biden stories]. Most prostate cancers are not a threat to a man’s longevity.”
However, Phillip Koo, MD, chief medical officer at the Prostate Cancer Foundation, said the screening landscape is shifting as treatment options have expanded. The most common treatment for early prostate cancer is tumor removal, which can often be done in an outpatient setting via laparoscopic or minimally invasive surgery.
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