Prostate screening: should you or shouldn't you?

AUA Responds to USPSTF Final Recommendations on Screening for Prostate Cancer

A recommendation issued Tuesday by the U.S. Preventive Services Task Force judged the "net benefits" of screening these men for prostate cancer to be small.

The PSA test is a simple blood test that attempts to identify men at risk of prostate cancer, but false-positive results can lead to over-diagnosis and unwanted side effects like incontinence and erectile dysfunction. The panel said that men aged 55 to 69 years should consult with their physicians to discuss the benefits and harms of getting a screening.

These updated recommendations are largely based on the European Randomized Study of Screening for Prostate Cancer trial conducted in 2014, which showed that screening for prostate cancer using PSA testing can prevent one cancer-related death and three cases of metastatic disease for every 1,000 men between 55 and 69 who are screened. The panel said there's evidence that "active surveillance", which involves repeated PSA testing and close monitoring, can help men diagnosed with cancer avoid harsh treatment or at least delay it. "Prostate cancer is almost 100 percent survivable if caught early and screening is the best way to do that".

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"Different men will weigh the potential benefits and harms differently, so the most important thing for them to do is talk with their doctor - armed with the research and guidance provided by our recommendation - so that they can make an informed decision based on their values and individual situation", Krist said. These specific patients should speak with their clinicians about whether prostate cancer testing is appropriate for them. Clinicians should not screen men who do not express a preference for screening. These men include African-Americans and those with a family history of prostate cancer, especially if a father or brother developed the disease before age 70.

It's recommending men older than 70 not get screened.

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