The U.S. Preventive Services Task Force recently published guidelines recommending against routine screening of men for prostate cancer. The task force said:
“The U.S. Preventive Services Task Force (USPSTF) recommends against prostate-specific antigen (PSA)-based screening for prostate cancer…This recommendation applies to men in the U.S. population that do not have symptoms that are highly suspicious for prostate cancer, regardless of age, race, or family history. The Task Force did not evaluate the use of the PSA test as part of a diagnostic strategy in men with symptoms that are highly suspicious for prostate cancer. This recommendation also does not consider the use of the PSA test for surveillance after diagnosis and/or treatment of prostate cancer.”
“As detailed in the report, published in the Annals of Internal Medicine on Oct. 11, 2011, these recommendations are based on conflicting data and available data do not evaluate newer therapies or refinements in existing therapeutic modalities.
“The Scripps Cancer Center urges caution against wholesale adaptation of these guidelines. Prostate cancer screening has been shown to reduce prostate cancer mortality by 6.1% in men under age 65, although there are conflicting data. Men with a family history of prostate cancer or African-American men have a higher risk of developing prostate cancer than their Caucasian counterparts. We feel these populations continue to require special attention, as do men with significant urinary symptoms.
“We therefore continue to recommend PSA-based prostate cancer screening for the following:
- African-American patients – screening should begin at age 40
- Men with a family history of prostate cancer – screening should begin at age 40
- Men with significant urinary symptoms – these patients should be evaluated by their physician, including a PSA, when appropriate
- Any patient requesting prostate cancer screening
“Finally, every man should have a candid discussion with his physician about the benefits and risks of screening for any cancer, including prostate cancer. It is vitally important that each patient has his concerns addressed, and actively participates in all health care decisions. It is clear that additional research is required to address the disparate data on PSA-based screening for prostate cancer.”