New recommendations for prostate cancer screenings

New recommendations for prostate cancer screenings

Many more men are expected to experience the harms of screening and treatment than will experience benefit. PSA screening is among the most heated topics in men's health.

The USPSTF bases its recommendations largely on prospective trials, which the scientific community doesn't have a lot of in the area of prostate cancer screening. Some cancers, ironically the ones easiest to diagnose and cure, are so slow-growing they are of no threat to the patient: They do not need to be cured, as they would never do harm if left alone. Ultimately the goal of the PSA test is to identify cancer earlier on before it becomes terminal. The results led to unneeded biopsies, radiation, or surgeries that had life-altering side effects.

The Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. "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".

"I'm very pleased. I view this as a victory for PSA screening for prostate cancer", says Dr. William Catalona, a professor of urology at the Northwestern University Feinberg School of Medicine.

For men age 70 and older, the group continues to conclude that any benefits of screening 'do not outweigh the harms'. It does not recommend earlier testing for blacks and those with a family history but says they should know their risks are higher. Read the new advice here.

The PSA test measures the amount of prostate-specific antigen, a type of protein, in a man's blood. "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". Since then, PSA screening rates have declined by as much as 10 percent, and now fewer than one-third of US men get the tests.

Taylor was diagnosed with Stage IV cancer and was put on an aggressive treatment regimen at the MD Anderson Cancer Center in Houston that has included surgery, chemotherapy and immunotherapy.

A local prostate cancer researcher applauds new PSA recommendations from a government task force.

"The importance of PSA testing is that it's bringing men into contact with the healthcare system", said Dr. Ramon Perez, an urologist and advisor to MHN.

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In breast cancer, the concern expressed by many studies has been that mammography screening doesn't result in significantly lower death rates from the disease. The panel reviews evidence and issues advice for a variety of screenings and treatments.

Critics of that recommendation anxious that as a result of any reduction in testing, prostate cancer might be diagnosed at a more advanced stage in some men.

The guideline is not final and remains open for public comment until May 8.

The task force's draft recommendation comes six months after it issued its findings in preliminary form.

"That only about a third of patients [in the study] reported having a discussion of advantages and disadvantages is an alarming statistic", study author Dr. George Turini III said in a news release from the Rhode Island university.

"A test ought to empower a patient and a doctor to have an intelligent conversation about what they need and what they don't need", Taylor said.

Some groups are at higher risk for prostate cancer, including African-American men and those with a family history of the disease. The new draft guideline leaves that in place for men 70 and older but gives a C grade to screening for men ages 55 to 69, signaling that the decision should be an individual one after consultation with a physician. In 2008, the group said there was too little evidence to make any kind of recommendation for younger men but said those 75 and older shouldn't be screened.

There are more African American men in North Carolina dying of prostate cancer than any other state in the country.

"PSA screening saves lives", he says. Prostate cancer is the most common cancer in American men; the American Cancer Society projects more than 161,000 new cases this year in the US, with about 26,730 deaths.

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