USPSTF updates PSA-based screening guideline for prostate cancer
On May 8, the Journal of the American Medical Association released an update to the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation regarding prostate-specific antigen (PSA)-based screening for prostate cancer.
The 2018 update states, for men between the ages of 55 and 69, the decision to undergo PSA-based screening for prostate cancer is dependent on the individual and a discussion reviewing the potential risks and benefits of screening should be thoroughly discussed with a clinician. A patient's family history, race/ethnicity, medical conditions, values regarding the benefits and risks of screening and treatment outcomes should also be discussed, according to the update.
Men 70 years and older should not be undergo PSA-based screening for prostate cancer, the USPSTF adamantly stated. Although screening may reduce mortality rates from prostate cancer, men may experience potential risks, including false-positive results that require additional testing and possible prostate biopsy, over diagnosis and various treatment complications.
Although the lifetime risk of being diagnosed with prostate cancer for men in the U.S. is 12 percent with an overall mortality risk of 2.5 percent, symptoms may not show and can go undiagnosed and untreated without undergoing screening, according to the USPSTF. Additional motivations for the recommendation update include the fact that black men have the highest risk of developing prostate cancer.
Data collected by the USPSTF from randomized trials showed that PSA-based screening programs may only prevent 1.3 deaths in men with prostate cancer over approximately 13 years per 1,000 men. Additionally, screening programs may prevent approximately three cases of metastatic prostate cancer per 1,000 men screened, according to the USPSTF.
"The USPSTF reviewed the evidence on the benefits and harms of PSA-based screening for prostate cancer and subsequent treatment of screen-detected prostate cancer... commissioned a review of existing decision analysis models and the over diagnosis rate of PSA-based screening...[and] also examined the benefits and harms of PSA-based screening in patient subpopulations at higher risk of prostate cancer, including older men, African American men, and men with a family history of prostate cancer," the USPSTF wrote.
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.