A 40-year-old African American patient is at increased risk of developing prostate cancer, since his father was diagnosed with the disease at age 60 and his brother at age 56. What diagnostic measures should be undertaken?

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The current recommendation of the American Cancer Society and the AmericanUrological Association is that men at increased risk of prostate cancer, such as thispatient, who has two risk factors, his race and his family history, should begin screeningwith an annual digital rectal exam (DRE) and prostate-specific antigen (PSA)measurement starting at age 45. The general population is advised to undergo thisprocess starting at age 50. It is important to note that PSA levels can be a marker ofeither benign prostatic hyperplasia or cancer, and there is some degree of controversyregarding the benefit of screening for it. Although transrectal ultrasonography maydetect small cancers, its prohibitive cost excludes its routine use in screening

A 40-Year-Old African American Patient Is at Increased Risk of Developing