Prostate Cancer in Older Adults: Risk of Clinically Meaningful Disease, the Role of Screening and Special Considerations

Purpose of Review Prostate cancer is the second most common cancer in men in the USA and several studies suggest more aggressive disease in older patients. However, screening remains controversial, especially in the older patient population. Recent Findings Aggressive prostate cancers are more commo...

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Bibliographic Details
Published in:Current oncology reports 2021-11, Vol.23 (11), p.130-130, Article 130
Main Authors: Robin, Tyler P., Geiger, Christopher L., Callihan, Eryn B., Kessler, Elizabeth R.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biomarkers
Biopsy
Cancer screening
Clinical significance
Decision making
Geriatric Oncology (L Balducci
Humans
Life span
Magnetic resonance imaging
Male
Mass Screening
Medical screening
Medicine
Medicine & Public Health
Metastases
Multiparametric Magnetic Resonance Imaging
Oncology
Prostate cancer
Prostate-Specific Antigen - analysis
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - epidemiology
Prostatic Neoplasms - pathology
Section Editor
Topical Collection on Geriatric Oncology
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Summary:Purpose of Review Prostate cancer is the second most common cancer in men in the USA and several studies suggest more aggressive disease in older patients. However, screening remains controversial, especially in the older patient population. Recent Findings Aggressive prostate cancers are more common in older men. Screening trial results are conflicting but data suggest an improvement in prostate cancer mortality and increased detection of metastatic disease with screening. When PSA is utilized with multiparametric MRI and biomarker assays, patients at significant risk of clinically meaningful prostate cancer can be appropriately selected for biopsy. Summary A thoughtful and individualized approach is central when considering prostate cancer screening in older men. This approach includes life expectancy estimation, use of appropriate geriatric assessment tools, use of multiparametric MRI and biomarkers in addition to PSA, and most importantly shared decision-making with patients.
ISSN:1523-3790
1534-6269
DOI:10.1007/s11912-021-01118-7