Published: Wed, April 12, 2017
Health Care | By Jeffery Armstrong

What to know about new advice on prostate cancer test

What to know about new advice on prostate cancer test

The USPSTF performed a systematic review of the existing evidence and concluded that the potential benefits and harms of prostate-specific antigen (PSA)-based screening are "closely balanced" in men aged 55-69 years and that it should be an individual decision whether to undergo screening or not (C Recommendation).

CHICAGO (AP) - An influential US government advisory panel is dropping its opposition to routine prostate cancer screening in favor of letting men decide for themselves after talking with their doctor.

Because "research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment", it says, men should discuss the pros and cons of PSA screening starting at age 50 (but 45 if you're African-American or have a father or brother who had prostate cancer before age 65). "And having the U.S. Preventive Services Task Force discourage PSA screening has sort of created a whole generation of family practitioners and internists who feel that PSA screening is a bad thing to do for patients". Medicare and many private insurers have continued to pay for the screening. The PCEC is dedicated to saving lives through awareness and the education of men, the women in their lives, as well as the medical community about prostate cancer prevalence, the importance of new marker utilization, and available treatment options, as well as other men's health issues.

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 USPSTF's new recommendation points to the need to prioritize research on high-risk groups like African-Americans and those with a family history of the disease, as well as continue to demonstrate the effectiveness of diagnostic tools to determine aggressive disease.

In prostate cancer, most men do not develop lethal disease. "Some men will want to avoid the chance of dying of prostate cancer no matter what, while others, given the side effects, will not think the benefits are worth it". The panel found that for every 1,000 men screened (or offered PSA screening), 240 would have a positive result.

"Some men who are very concerned about prostate cancer will elect to be screened, and others who are less concerned will elect not to be screened; either decision should be supported", he wrote. After the comment period ends, the task force will consider the input and come up with its final recommendation in the following months. One epidemiologic study suggests that more than 1 million American men received unnecessary treatment over the past 25 years.

Dr. Krist is an associate professor of family medicine and population health at Virginia Commonwealth University and an active clinician and teacher at the Fairfax Family Practice Residency.

MHN believes that the Task Force's latest findings will encourage more men to talk to their medical providers about prostate cancer screening. In this approach, doctors keep a close eye on men with a high risk of prostate cancer, rather than treating outright.

More than 161,000 men in the United States will be diagnosed with prostate cancer in 2017, according to the American Cancer Society and almost 27,000 will die at an average age of 80.

"There is probably a small benefit overall to screening", said task force chair Dr. Kirsten Bibbins-Domingo. Now, a national task force that recommended against the PSA test is shifting its stance. For men who are more willing to accept the potential harms, screening may be the right choice for them. Men who were diagnosed with prostate cancer were rushed to treatment with surgery, radiation or hormones.

And if someone has a slow-growing prostate cancer that doesn't necessarily need treatment, the emotional distress of a cancer diagnosis shouldn't be underestimated, Turini said.

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