There’s No Blanket Prostate Cancer Screening Recommendation. Here’s Why

Last week, Joe Biden was diagnosed with an "aggressive" form of prostate cancer — one that has metastasized to his bones. The discovery of a prostate nodule was made after he sought medical care for "increasing urinary symptoms," according to a statement released directly from his office. Although it was only just discovered, it’s been classified with a Gleason Score of 9 and Grade Group 5 — among the most aggressive of the type.

Some are surprised to learn that Biden is only just discovering this life-altering illness at such a late stage. But in fact, it’s not unheard of for men of a certain age to forgo regular screenings.

And for some, Biden’s diagnosis has sparked a debate about whether or not that’s OK.

Who should — and should not — be screened for prostate cancer, and why?

Unlike breast cancer and colorectal cancer, there’s no blanket recommendation by the U.S. Preventative Service Task Force (USPSTF) for regular prostate cancer screenings for all adults. Instead, it suggests that men ages 55 to 69 should discuss screening with their doctor based on their individual risk factors — while for men ages 70 and older, the organization recommends against screening entirely.

The American Cancer Society also avoids offering a blanket screening recommendation, instead stating the importance that "men have a chance to make an informed decision with their health care provider about whether to be screened for prostate cancer." (The organization does lower the age of that discussion to 50 for men at average risk, 45 for men at higher risk and 40 for men at the highest risk level, such as those who have more than one first-degree relative who developed prostate cancer at an early age.)

Although the primary prostate cancer screening is a noninvasive blood test — which screens for blood levels of prostate-specific antigen (PSA) — the USPSTF notes that "many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction."

However, the Prostate Cancer Foundation says that men should begin discussing screening with their doctors as early as their 40s. "Prostate cancer often has no symptoms until the disease is advanced," the organization says — and which Biden unfortunately found out for himself. "Screening may help detect cancer early, when the chances of treatment success are high."

Biden’s cancer, according to the statement released by his office, is responsive to androgen-blocking hormone therapy — so while it may be incurable, it shows promise toward being effectively managed for some time.

Making informed decisions about screening for yourself or a loved one

While the potential downsides mentioned by the USPSTF are indeed scary for many men, some experts point to improved technology as an argument for increased screening. Phillip Koo, the Prostate Cancer Foundation’s chief medical officer, says that prostate tumor removal surgeries have become less invasive thanks to the increase of laparoscopic procedures, which could dial down the risk level men face.

Of course, at the end of the day, the only person who can make a decision about their health is the person whose health is in question — particularly when potential side effects could include loss of sexual function or incontinence. However, it’s important to understand that a prostate cancer diagnosis could be life-altering, or even deadly — as well as counting as a preexisting condition that could limit your ability to purchase life insurance.

Cancer is the second-leading cause of death in the United States behind heart disease, and many types are on the rise — especially in younger generations. Fortunately, though, the risk of dying from cancer is simultaneously dropping, a statistic likely owed to improved treatment and screening technologies.

Although most health insurance plans cover cancer treatment, costs can still be exorbitant, especially for advanced or terminal illness. Searching for the best health care or Medicare plan can help — as can making healthy lifestyle choices that can lower your cancer risk, such as avoiding alcohol or processed meat.