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US Panel Changes Recommendation on Prostate Cancer Screening

12 April 2017

The test diagnoses prostate cancer, but there are so many problems with it (anybody up for a false-positive?) that the USPSTF in 2012 recommended that doctors discourage men of all ages from getting the test. The new statement also recognizes that the decision on whether or not to have a PSA test should be specific to each individual and an informed decision following a conversation between a man and his physician.

Men's Health Network (MHN) is encouraged by the latest recommendations from the U.S. Preventative Services Task Force (USPSTF) that urges men to talk to their healthcare providers about when, or if, they need to be screened for prostate cancer.

A federal task force is walking back a 2012 recommendation that men between ages 55 and 69 not be screened for prostate cancer. New research shows testing men aged 55 to 69 may slightly reduce their chances of dying from prostate cancer.

For example, PSA screening - a blood test that looks for elevated levels of a protein - can result in a positive screen that requires diagnostic testing, which can lead to infection as well as treatment complications such as incontinence, impotence, bowel injury and even death.

The new draft guidelines released Tuesday echo those of several leading medical groups, but they don't make the decision any easier for men: With their doctor's help, they have to decide whether to take an imperfect PSA test that has a small chance of detecting a deadly cancer and a larger chance of triggering unneeded worry and treatment with serious side effects.

The task force draft recommendations apply to PSA tests for men without any symptoms that might point to prostate cancer.

Should middle-aged men get routine blood tests for prostate cancer? The latest data show that over 180,000 men were diagnosed with prostate cancer in 2016, but there were only 26,000 deaths from it. Prostate cancer accounted for 4.4 percent of all cancer deaths in the United States previous year. To access this information, review the draft recommendation statement and submit comments, go to: www.screeningforprostatecancer.org. Bibbins-Domingo said she thinks "it's highly unlikely that a reduction in screening led to a rise in metastatic disease", primarily because of the timing.

Editor's note: Otis Brawley is chief medical officer of the American Cancer Society.

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"At risk patients (men with a family history and black men) are more likely to die from prostate cancer, therefore these individuals are conceptually more likely to gain from PSA screening", Trinh, who wasn't involved in the task force recommendations, said by email.

The panel's shift is the latest chapter in a long saga over prostate-cancer screening. Marsha Blackburn, R-Tenn., and Bobby L. Rush, D-Ill., introduced legislation to "reform" the independent panel and add specialists to the prevention experts appointed by a federal health agency.

Prostate cancer is one of the most common types among men in the USA; almost 13 percent will be diagnosed with it over the course of their lifetimes, according to the National Cancer Institute.

"The importance of PSA testing is that it's bringing men into contact with the healthcare system", said Dr. Ramon Perez, an urologist and advisor to MHN.

In prostate cancer, most men do not develop lethal disease.

The draft prostate cancer recommendations, announced online in the Journal of the American Medical Association, are open for public comment on the task force website until May 8. "In the end, men who are considering screening deserve to be aware of what the science says, so they can make the best choice for themselves, together with their doctor". If you treated everyone who was diagnosed with prostate cancer, which is what used to be done, most men would not benefit.

The new guidance from the USPSTF is just a draft.

US Panel Changes Recommendation on Prostate Cancer Screening