When Screening for Prostate Cancer Comes Too Late

livemint.com:

Prostate cancer loomed over David Weigand’s family: His uncle had the disease, and his father died of it. Yet widely followed recommendations for prostate-cancer screening didn’t consider him eligible for a test. ​In 2021​, he got tested anyway at his partner Cody Green’s urging.

Weigand was 53 at the time​—two years below the age when the U.S. Preventive Services Task Force says men should consider testing​ for levels of prostate-specific antigen, or PSA​. He had no symptoms.

Weigand’s PSA levels were elevated. After a biopsy, he was diagnosed with stage-four cancer that had spread to lymph nodes in his pelvis. “My prostate was completely covered in cancer," Weigand said.

“The situation that I’m in was so preventable." Screening for prostate cancer is due for a course correction—again. Doctors have debated how often to screen men for prostate cancer for decades. Widespread screening after testing went mainstream in the 1990s led to overtreatment and damaging side effects for many men.

Doctors scaled back after the task force, which carries particular weight among family doctors and insurers, recommended against the test in 2012. About five years later, the task force said men ages 55-69 could consider it after talking with their doctors. More patients are now getting diagnosed with prostate cancer at later stages, when it is often too late to be cured.

A two-decade decline in death rates has stalled. Some doctors worry deaths could rise in coming years. “We’re finding them with disease not contained in the prostate but also in the bones, in the lymph nodes," said Dr.