President Joe Biden’s recent diagnosis of aggressive prostate cancer has sparked renewed debate about current prostate screening guidelines, especially for men over 70. Medical experts are questioning whether the existing recommendations may overlook risks that could be prevented with earlier detection.
The U.S. Preventive Services Task Force (USPSTF) advises men aged 55 to 69 to discuss PSA (prostate-specific antigen) screening with their doctor. However, the same task force recommends that men over 70 avoid PSA screening entirely, citing limited benefits and increased risks.
Dr. Shawn Dason, a urologic oncologist at The Ohio State University, says men in their 50s and 60s should talk to their doctors to decide whether screening is right for them. He emphasizes the importance of understanding the pros and cons of PSA testing, especially for early detection.
There is no clear agreement on PSA testing for men under 50 or over 70. Dr. Dason points out that these age groups may face over-treatment. Some cancers found in these groups may never cause harm, but the treatment itself can cause serious side effects.
Treatments for prostate cancer can cause lasting issues such as urinary, sexual, or bowel problems. Dason warns that these side effects can be more harmful than the cancer in cases where the disease might never have progressed to a dangerous stage.
PSA testing has declined since the USPSTF issued its guidance, even for men over 40. This trend concerns experts who worry about missed diagnoses. Some prostate cancers are slow-growing, but others can become life-threatening if not caught early.
Dr. Dason explains that there’s limited research showing that screening men over 70 saves lives. However, it is clear that treatment risks increase with age. For that reason, some doctors support selective screening for healthy men over 70.
Even men with no symptoms should consider screening, says Dason. Screening is meant for those without complaints but who are undergoing routine health checks. Symptoms would indicate a need for diagnostic tests rather than screening.
Fox News medical analyst Dr. Marc Siegel criticized current screening guidelines in an opinion piece. He argues that routine PSA screening should not stop at age 70, especially considering the high number of new prostate cancer cases and related deaths each year.
Siegel points out that prostate cancer treatments have improved significantly in recent years. These newer treatments come with fewer side effects, making screening more beneficial even for older men who may need care.
Some critics say a U.S. president should always receive aggressive cancer screening. But Siegel argues that all men over age 45—not just public figures—should receive PSA testing. He calls for universal access regardless of age.
Dason agrees that some men over 70 should be screened, especially if they are in good health and have a longer life expectancy. In those cases, early detection can significantly improve both lifespan and quality of life.
Screening may not be suitable for men with serious health issues or shorter life expectancies. In those cases, the risks of treatment may outweigh any benefit. Experts urge men to speak with their doctors to make informed, personal decisions.
