Mayo Clinic Talks Prostate Cancer Screening
Oct 28, 2025
Dr. Daniel M. Frendl, a urologist at the Mayo Clinic in Arizona, dives into the complexities of prostate cancer screening. He unpacks the controversies surrounding PSA testing and how it revolutionized cancer diagnosis rates in the '90s. Discussions include the role of the digital rectal exam and the impact of updated screening guidelines. Frendl emphasizes tailored screening starting at age 45, particularly for high-risk groups. He also highlights advancements like MRI-guided biopsy to improve specificity in detecting prostate cancer.
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DRE Is Not A Standalone Screen
- Do not use the digital rectal exam (DRE) as a standalone screening test for prostate cancer.
- Use DRE selectively, especially when PSA is elevated or for staging after biopsy.
PSA Increased Diagnoses And Overdiagnosis
- The introduction of PSA greatly increased prostate cancer diagnoses by finding many low-risk tumors.
- That led to overtreatment and controversy about routine annual PSA screening.
Have Shared Decision-Making For Ages 55–69
- Discuss PSA screening with men aged 55–69 rather than blanket screening or complete avoidance.
- Recognize harms of biopsy (sepsis risk) and weigh risks and benefits before screening.