Saturday, May 12, 2018

What should men do about prostate cancer screening?

For years, men were urged to get a blood test looking for prostate-specific antigen (PSA), which can be elevated by prostate cancer. Then, in 2012, the United States Preventative Services Task Force (USPSTF), a government-sponsored but independent network of national experts in disease prevention and evidence-based medicine, said that PSA testing produced more harm than good. They stopped recommending it at all.
Now, that same group has finalized a tweak on those 2012 screening guidelines. Instead of bypassing PSA entirely, men ages 55 to 69 should have a conversation with their doctor about the risks and benefits before making their own decision on whether or not to get screened.
What patients need to know about new recommendations for prostate cancer screening
The task force says the change was largely driven by a 2014 study in Europe (European Randomized Study of Screening for Prostate Cancer), according to a new statement and evidence review published Tuesday in the Journal of the American Medical Association (JAMA).
The European trial showed that a screening saved one prostate cancer deaths for every 1,000 men screened between ages 55 and 69. In four out of the seven countries in the European trial, screening also stopped three cases of prostate cancer from spreading for every 1,000 men screened.
Dr. Alex Krist, vice chairman of the USPSTF and a professor of family medicine and population health at Virginia Commonwealth University, says the “extended follow up of 10 plus years in these studies, which was not available in 2012, contributed heavily” to the decision to modify the recommendations.
The extended follow up showed some men’s lives would be saved if they chose to be screened between the ages of 55 to 69. Of note, the committee still finds screening for men over the age of 70 to be inappropriate -- the evidence still suggests more harm than benefit in this age group.

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