A 40-year-old African American patient is at increased risk of developing prostate cancer, since his father was diagnosed with the disease at age 60 and his brother at age 56
What diagnostic measures should be undertaken?
A)
PSA and DRE starting before the age of 50
B)
Transrectal ultrasonography starting immediately
C)
PSA and DRE starting at age 50
D)
Transrectal MRI starting at age 45
Ans:
A
Feedback:
The current recommendation of the American Cancer Society and the American Urological Association is that men at increased risk of prostate cancer, such as this patient, who has two risk factors, his race and his family history, should begin screening with an annual digital rectal exam (DRE) and prostate-specific antigen (PSA) measurement starting at age 45. The general population is advised to undergo this process starting at age 50. It is important to note that PSA levels can be a marker of either benign prostatic hyperplasia or cancer, and there is some degree of controversy regarding the benefit of screening for it. Although transrectal ultrasonography may detect small cancers, its prohibitive cost excludes its routine use in screening.
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