More aggressive prostate cancer in elderly men.

More than one-fifth of men who are diagnosed with prostate cancer are age ≥ 75 years.1 However, prostate cancer screening and treatment are both controversial in elderly men. In 2008, the US Preventive Services Task Force recommended against prostate-specific antigen (PSA)-based screening in men aged ≥ 75 years. This recommendation, which has been expanded to include all men,2 generated controversy by focusing on chronologic age rather than health status.3, 4 More recently, the American Urological Association issued new guidelines stating that they do not recommend routine PSA screening in men aged > 70 years or those with less than a 10- to 15-year life expectancy, although some older men who are in excellent health may benefit from prostate cancer screening.5 This review describes two recent studies on the tumor features and outcomes of prostate cancer in elderly men.6,7