Over the last few years, there have been several studies that suggest that men with BRCA mutations are at a higher risk for developing and dying from aggressive prostate cancer. It is possible that PSA testing may be of benefit in men with BRCA mutations. However, until the utility of PSA is determined in these men, national practice guidelines continue to recommend annual prostate cancer screening (through PSA test and digital rectal exam) starting at age 40 in men with BRCA mutations. Of note, new recommendations were set forth by the U.S. Preventive Services Task Force (USPSTF) which consists of a panel of national experts. Part of their mission is to make recommendations about preventive services, such as the use of PSA screening in men. The task force revised their position on PSA screening and recently recommended against routine prostate screening for everyone. However, in May 2012, they included the following caveat: This recommendation also does not include the use of the PSA test for surveillance after diagnosis or treatment of prostate cancer and does not consider PSA-based testing in men with known BRCA gene mutations who may be at increased risk for prostate cancer.” Thus, they now indicate that those who may be at a higher risk for prostate cancer, such as BRCA mutation carriers, are not part of the recommendations and therefore it is reasonable to continue screening these individuals using the PSA test.
US Preventive Services Task Force, Moyer et al. Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2012 May. PMID: 22801674. Available at: https://www.annals.org/aim/fullarticle/doi/10.7326/0003-4819-157-2-201207170-00459