Prostate cancer screening in men with Down syndrome

The (US) Adult Down Syndrome Clinic posted this advice on their Facebook page on 5th June.  It refers to current US recommendations.  The ADC's advice for screening in men with Down syndrome is congruent with the current Australian recommendations for all men (links below):


Should we do PSA screening for prostate cancer in men with Down syndrome? We have not been recommending prostate screening based on these thoughts:

PROSTATE CANCER SCREENING
Prostate specific antigen (PSA) testing (blood test) is recommended for men in the general population who are age 50 and over to screen for prostate cancer. It is recommended by the American Cancer Society to do this exam in those men who have a life expectancy of at least 10 years. 


For the following reasons, I generally do not recommend PSA testing in adult men with Down syndrome:

• The life expectancy of a person with Down syndrome is 56 years.
  
• Prostate cancer is believed to be less common in people with Down syndrome.
  
• There is great deal of false positive results in PSA testing. This means that while the test suggests there is prostate cancer, the person does not actually have prostate cancer. A positive result necessitates additional testing including an ultrasound through the rectum, as well as a biopsy of the prostate through the rectum. Generally, in our patients with Down syndrome this would require a significant amount of anesthesia. This would cause greater risk for follow-up testing.

However, the latest recommendation is against PSA screening for anyone. Please see the article through the link. 


Current Australian recommendations for all men

Cancer Council Australia and the Australian Health Ministers' Advisory Council:

Prostate cancer screening: joint key messages (last reviewed May 2010)


Cancer Council of Australia: 
Prostate cancer screening (last reviewed June 2010)