From the Guidelines
The USPSTF does not recommend screening for prostate cancer or testicular cancer in young males presenting for sports physical examinations, beyond a standard history and physical examination. This recommendation is based on the lack of evidence that such screenings improve health outcomes in asymptomatic young males, as stated by the USPSTF in their recommendation statements 1. The USPSTF emphasizes the importance of evidence-based preventive services that have demonstrated benefits exceeding potential harms. For young athletes, this means targeted screening based on individual risk factors identified through a comprehensive medical history rather than universal additional screening procedures. Some key elements to focus on during a sports physical examination include:
- Cardiovascular screening through history and physical examination
- Blood pressure measurement
- Vision screening
- Assessment of musculoskeletal function relevant to the specific sport The USPSTF approach helps avoid unnecessary testing while ensuring appropriate evaluation of sport-specific health concerns. Therefore, option A is the correct answer, as it aligns with the USPSTF's recommendation against screening for prostate cancer or testicular cancer in asymptomatic young males. Options B, C, and D are incorrect because they suggest performing screenings that are not recommended by the USPSTF for young males presenting for sports physical examinations 1.
From the Research
Screening Recommendations for Young Males
According to the USPSTF, the following are recommended for a young male presenting for a sports physical examination:
- The USPSTF does not recommend screening for prostate cancer or testicular cancer in this patient 2, 3
Prostate Cancer Screening
The USPSTF recommends against PSA-based screening for prostate cancer in men under 55 years and over 70 years 2
- For men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician 2
Testicular Cancer Screening
The USPSTF recommends against testicular self-examination (TSE) and clinical evaluation to screen for testicular cancer in asymptomatic males 3
Digital Rectal Examination (DRE)
DRE is not a useful screening test for prostate cancer, especially in young men 4
Key Points
- The USPSTF does not recommend routine screening for prostate or testicular cancer in young males 2, 3
- PSA-based screening for prostate cancer may be considered for men aged 55 to 69 years, but the decision should be individualized 2
- DRE is not recommended as a screening test for prostate cancer in young men 4