Understanding Prostate Cancer Screening And Prevention

August 12, 2023

By Dr. Graham A. Colditz
Siteman Cancer Center

Prostate cancer isn’t a pleasant topic to think about. But at the same time, it’s a cancer that many of us are, unfortunately, familiar with. It’s likely impacted people in our lives, whether it’s family members, friends or those we know through school or work. So, whether it’s for ourselves or those we care about, it is important to better understand the disease and steps that may help protect against it.

Prostate cancer is the second most common cancer in the U.S., just behind breast cancer, but it is the most common cancer in men, with close to 290,000 cases diagnosed each year. And like many other health issues, prostate cancer doesn’t impact everyone equally – with African American men much more likely to develop and die from the disease than other groups.

So, what is the prostate, exactly? It’s a gland about the size of a ping pong ball that’s part of the male reproductive system. It sits just below the bladder, circling the tube that empties urine from the body.

Problems with prostate health become more common as men age, and prostate cancer is found most often between ages 65-74. Being African American and having a family history of the disease can also increase risk significantly.

Screening for prostate cancer has been shown to lower the risk of dying of the disease. When found in early stages, prostate cancer has a 100 percent five-year survival rate. But unlike other types of cancer screenings, there can be a more subtle balance between the potential harms and benefits of screening when it comes to prostate cancer. This is largely because some prostate cancers are slow-growing and may never cause any serious health issues. However, others are very aggressive and men will benefit from early diagnosis and treatment.

Because of this, the American Cancer Society recommends that men have an in-depth conversation with their doctors about the possible benefits and harms of prostate cancer screening before deciding if it’s right for them. Men at normal risk of prostate cancer should have this conversation starting at age 50. African American men – who are diagnosed with aggressive prostate cancer more often than men from other races – should have this discussion starting at ages 45. Men with a strong family history of the disease should have this discussion starting at ages 40-45.

It’s never too early, though, to take steps that can help prevent serious prostate cancer. Behaviors that we know can lower risk include:
• Not smoking. If you smoke, try to quit as soon as possible. Visit smokefree.gov for help. If you don’t smoke, be sure to stay smoke-free.
• Keeping weight in check. Being physically active can help control weight gain, even if it’s a few minutes here and there added up throughout the day. Other tips include: cutting back on sugary soda and fast food.
• Eating tomatoes and tomato-based foods. Try to add salsa, red pasta sauce, and other tomato dishes to weekly meals. Among other nutrients, tomatoes are high in lycopene, which may help lower the risk of some cancers, including prostate cancer.

Whether it’s through making healthy lifestyle choices or talking to a doctor about screening, there are important steps men can take to look after their prostate health. That can mean a lot to family, friends and others in their lives.

It’s your health. Take control.

Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.