Task Force Recommends Against Routine Prostate Cancer ...

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Article date:
May 21, 2012

By Stacy Simon

The United States Preventive Services Task Force (USPSTF) has expelled new recommendations opposite prostate cancer screening. The USPSTF now recommends that regardless of age, group but symptoms should not customarily have a prostate-specific antigen (PSA) blood exam to shade for prostate cancer.

The charge force is an eccentric row of experts certified by Congress to make recommendations about specific surety services for patients with no signs or symptoms. It expelled a breeze of these recommendations in October, 2011.

In a final prostate screening recommendations, a charge force concludes that, formed on a stream evidence, there is during slightest assuage certainty that a harms of PSA contrast transcend a benefits.

The USPSTF recommendation differs somewhat from those of many other consultant groups, including a American Cancer Society. The American Cancer Society recommends group make an sensitive preference about either to be tested after training about a intensity risks and advantages of testing.

The USPSTF does, however, commend that some group will continue to ask PSA screening and some doctors will continue to offer it. The charge force encourages patients and doctors to make an sensitive preference formed on a patients? preferences and an bargain of a probable risks and benefits.

Potential harms and advantages of screening

The charge force final published recommendations on prostate cancer screening in 2008. At that time, it resolved that group over 75 should not be screened and that there was not adequate justification to suggest for or opposite screening in younger men.

The new USPSTF recommendations, published early online May 21, 2012 in Annals of Internal Medicine, are formed mostly on reviews of dual vast clinical trials of prostate cancer screening that have been published given 2008.

The categorical idea of prostate cancer screening is to revoke deaths due to prostate cancer. But a studies showed that a series of group who avoided failing of prostate cancer since of screening after 10 to 14 years was really small. In addition, a PSA exam mostly produces false-positive formula that lead to some-more testing, including biopsies, that can have their possess side effects, according to a USPSTF.

Prostate cancer mostly grows so solemnly that many group who have it rescued during screening competence never need treatment. Treatment itself can mostly have unpleasant, and infrequently long-lasting, side effects. One of a problems with prostate cancer screening is that it can't establish that prostate cancers are assertive and need treatment, and that are not expected to means problems. As a result, many group diagnosed with prostate cancer also get active treatment.

The charge force remarkable that scarcely 90% of group with PSA-detected prostate cancer go on to have surgery, radiation, or hormone therapy. Up to 5 in 1,000 group will die within 1 month of surgery, and during slightest 20% and 30% of group removing medicine or deviation therapy will have critical long-term side effects such as urinary incontinence, erectile dysfunction, or bowel dysfunction. Hormone therapy is also compared with erectile dysfunction, breast enlargement, and prohibited flashes.

Prostate cancer is a many common cancer in American group (other than skin cancer) and occurs some-more mostly in African-American men. It strikes some-more than 240,000 group any year and kills about 28,000.

Not all experts agree

In an concomitant editorial, William J. Catalona, MD, Medical Director of a Urological Research Foundation and colleagues disagreed with a USPSTF recommendations. They trust that a charge force underestimated a advantages and overestimated a harms of prostate cancer screening, and that a trials on that a charge force formed a conclusions were flawed. Catalona and colleagues endorsed that doctors examination a justification for themselves, and make particular decisions about prostate cancer screening formed on a preferences of an sensitive patient.

In a second editorial, Otis W. Brawley, MD, MPH, Chief Medical Officer of a American Cancer Society, also stressed a need for sensitive decision-making, as a American Cancer Society and many other organizations recommend.

Brawley wrote that over-diagnosis of prostate cancer can make screening seem to save lives when it might not. Many group are diagnosed with prostate cancer that might never have progressed within their lifetime; nonetheless since they were screened and treated, they consider screening saved their lives.

Brawley wrote, ?Americans have been taught for decades to fear all cancer and that a best approach to understanding with cancer is to find it early and provide it aggressively. As a result, many have a blind faith in early showing of cancer and successive assertive medical involvement whenever cancer is found. There is small appreciation of a harms that screening and medical interventions can cause.?

The American Cancer Society recommends that group plead a probable risks and advantages of prostate cancer screening with their alloy before determining either to be screened. The contention about screening should take place during age 50 for group who are during normal risk of prostate cancer and during age 45 for group who are during aloft risk, including African-American group and group who have a father or hermit diagnosed with prostate cancer.

Reviewed by: Members of a ACS Medical Content Staff

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ACS News Center stories are supposing as a source of cancer-related news and are not dictated to be used as press releases. For reprint requests, greatfully hit permissionrequest@cancer.org.

Citations: Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement. Published early online May 21 in Annals of Internal Medicine. First author: Virginia A. Moyer, MD, PhD, Baylor College of Medicine, Houston, Texas.

Screening for Prostate Cancer: A Review of a Evidence for a U.S. Preventive Services Task Force. Published early online May 21 in Annals of Internal Medicine. First author: Roger Chou, MD, Oregon Health Science University, Portland, Ore.

What a U.S. Preventive Services Task Force Missed in Its Prostate Cancer Screening Recommendation. Published early online May 21 in Annals of Internal Medicine. First author: William J. Catalona, Northwestern University, Chicago, Ill.

Prostate Cancer Screening: What We Know, Don?t Know, and Believe. Published early online May 21 in Annals of Internal Medicine. First author: Otis W. Brawley, MD, MPH, American Cancer Society, Atlanta, Ga.

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