The US Preventive Services Task Force recently released a draft statement with updated advice for the use of Prostate Specific Antigen (PSA) in screening for prostate cancer. They will be accepting public feedback regarding their recommendations until May 8, 2017, after which time a final recommendation will be released.
Back in 2012, the USPSTF unequivocally told doctors to discourage patients from getting PSA testing. They stated that the risks of false positives and overtreatment outweighed the benefits. But after much debate, the USPSTF has backed off that advice.
Here is the upshot of their updated recommendations from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/prostate-cancer-screening1
▪ PSA tests for men age 70 and older and men under age 55 are still discouraged
▪ For men between 55 and 69, the panel is punting the decision to doctors.
“The decision about whether to be screened for prostate cancer should be an individual one. Screening offers a small potential benefit of reducing the chance of dying of prostate cancer. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and impotence. The USPSTF recommends individualized decision making about screening for prostate cancer after discussion with a clinician, so that each man has an opportunity to understand the potential benefits and harms of screening and to incorporate his values and preferences into his decision.”
▪ The task force backed down on its earlier advice in light of new evidence. Back in 2012, the best evidence suggested that for every 1,000 men screened, 0.8 prostate cancer deaths would be prevented in the next 10 to 15 years. But a longer look at the participants in prostate cancer studies has raised that to 1.3 deaths prevented in the same time frame. Additionally, studies have since reported that screening 1,000 men ages 55 to 69 years may prevent approximately 3 men from developing metastatic prostate cancer.
▪ The panel also took into consideration that how men seek treatment has shifted. More men now who receive cancer diagnoses are opting for active surveillance — watching their cancer closely — rather than treatment. That lessens the potential harms, such as impotence and incontinence after surgery; compared to the last time the task force evaluated the screenings.
More detailed information is in CaSfA's April 18, 2017 newsletter. Join CaSfA to receive our newsletters!!