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Source: Maine Cancer Registry 280 - Estimated number of prostate cancer deaths in Maine (2008). Source ACS 170.2  Estimated incidence of prostate cancer in Maine v. 160.8 Nation. Source ACS 28.5  Estimated Prostate Cancer death rate in Maine v 27.9 Nation. Source ACS f\ZG B   I  D   0Why Endorse Prostate Cancer Screening Guideline?11(jMaineHealth emphasizes use of evidence based practices. Maine PHO primary care physicians request clarity.  GuidelinesNScreening guideline for men at average risk no family or personal history of prostate cancer For men aged 50-74 OR For men aged 40+ if risk factors are present. Screening is not recommended for men age 75 or older. Screening decisions for men of any age should be individualized and made in concert with an informed patient.,P1PPPnP,1dm Guidelines continuedIf the patient is a candidate for screening (Prostate Specific Antigen and Digital Rectal Exam), discuss with patient the benefits and risks of screening and / or offer patient decision aids. If the patient decides to forego screening, ask the patient about the option to screen at each subsequent health maintenance visit or annually. If DRE is abnormal (for example; asymmetrical texture, nodule present), perform PSA and refer for consideration of transrectal ultrasound guided biopsy. If DRE is negative and PSA is <4, continue to offer screening at each health maintenance visit. If DRE is negative and PSA is e"4, and / or PSA has doubled in d" 3 years, perform a second PSA within 3 months and consider referral for transrectal ultrasound guided biopsy. 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