Screening for prostate cancer: who and how often?

Engage patients in shared decision making by discussing the benefits and risks of prostate cancer screening. Patients who review educational pamphlets before an office visit engage more fully in the decision-making process. If performing prostate cancer screening, limit to men with greater than 10 years life expectancy. Because the lead time of a diagnosis based on PSA screening is estimated to be 5 to 7 years, PSA screening every other year is unlikely to cause a loss of sensitivity. Men with tumors with a Gleason score less than 5 are the best candidates for "watchful waiting," having a favorable 20-year survival.