For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)–based screening for prostate cancer should be an individual one, recommends US Preventive Services Task Force (USPSTF) in its latest update. This literally means that Men between 55 to 69 years are now allowed to use their discretion for PSA Test. Prostate cancer is the second leading cause of cancer death among US men. In 2012, the US Preventive Services Task Force (USPSTF) had recommended against PSA-based screening for prostate cancer, concluding that there was moderate certainty that the benefits of screening do not outweigh the harms.
USPSTF has issued a final recommendation statement on screening patients for prostate cancer which also recommends that Prior to this decision, patients should discuss the potential benefits and harms of screening with their clinician, taking into account their specific clinical situation (family history, race/ethnicity, comorbid conditions) and personal values (recommendation).
Men aged ≥70 years, however, should not be routinely screened for prostate cancer as the potential benefits do not outweigh the harms (D Recommendation).
Task Force vice chair Douglas K. Owens has said “For men who are more interested in the small potential benefit and willing to accept the potential harms, screening may be the right choice for them. “Men who place more value on avoiding the potential harms may choose not to be screened” he adds.
An evidence review conducted by the Task Force revealed that for men aged 55–69 years has found that PSA-based screening programs prevented roughly 1.3 deaths over approximately 13 years per 1000 men screened. Conversely, possible harms associated with screening included false-positive results that required more testing and psychological harms.
The American Academy of Family Physicians and the Canadian Task Force on Preventive Health Care recommend against PSA-based screening for prostate cancer. The American College of Physicians recommends that clinicians discuss the benefits and harms of screening with men aged 50 to 69 years and only recommends screening for men who prioritize screening and have a life expectancy of more than 10 to 15 years. The American Urological Association recommends that men aged 55 to 69 years with a life expectancy of more than 10 to 15 years be informed of the benefits and harms of screening and engage in shared decision making with their clinicians, taking into account each man’s values and preferences.
For further reference log on to : doi:10.1001/jama.2018.3710
Dr. Kamal Kant Kohli
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