Prostate cancer tests are now OK with panel, with caveats

Men ages 55 to 69 could have PSA testing.

That is why the US Preventive Services Task Force issued a new draft prostate cancer screening recommendation Tuesday. "The newer recommendation should empower men to be proactive about learning about the benefits and risks of screening and not avoid asking about it because their personal physician is not a believer in screening and never even broaches the subject; men should ask for the facts and not be shy about asking to have a PSA ordered if they feel it's in their interest to do so". But first, they should have a talk with their doctor about the pros and the cons of the PSA test. "The right decision isn't screening all men, it's making all men aware of the benefits and harms, and then allowing each man to make the best decision for himself", Bibbins-Domingo explained. It involves a simple blood test for elevated levels of a protein that may signal cancer but also can be caused by less serious prostate problems. However, doctors can't tell the sluggish cancers from the killer ones. While many prostate cancers cause no problems, men may opt for radiation or surgery, which can cause sexual impotence and/or bowel and bladder problems.

The task force is an independent, volunteer panel of experts in prevention and evidence-based medicine that makes recommendations about preventive medical services, such as screenings, counseling services, and preventive medications. That is, there is moderate certainty of the test reducing the chance of men dying of prostate cancer, but many men will experience potential harms simply from the screening. An influential health panel that once said no now says certain men may benefit as long as they understand the potential harms.

The draft recommendation was published on the task force's website on April 11, and it is open to public comment until May 8. The biggest remaining difference is timing.

"The balance has shifted", she added, "and now we can recommend that men have a conversation with their doctors about screening".

Yes, it acknowledges that African-American men and men with a family history of prostate cancer are at a higher risk for deadly prostate cancer. He says he wishes the group had gone further and recommended that doctors actively encourage PSA screening beginning at age 40 and continuing past age 70. But the association expressed concern that, under the guidelines, men 70 and older would not be screened for prostate cancer.

"While we're pleased to see that the USPSTF has acknowledged the value of PSA testing, the recommendation leaves gaps in how to effectively address screening - especially in high-risk populations that also include military veterans exposed to Agent Orange", said Us TOO International CEO Chuck Strand.

Dr. Meir Stampfer, a Harvard University cancer expert, called the new advice "a more reasoned approach".

There are two primary prostate cancer screening tests: the digital rectal exam and the prostate-specific antigen (PSA) test. Find out when and how often you should get screened.

Dr. Alex Krist, a member of the USPSTF task force and a family medicine doctor at Virginia Commonwealth University in Richmond, said a high PSA may not necessarily point to prostate cancer. Since then, PSA screening rates have declined by as much as 10 percent, and now fewer than one-third of USA men get the tests.

Davies estimated that, prior to 2012, bout 50 percent of men diagnoses with prostate cancer received unnecessary treatment.

The new recommendation is a reversal from the one they issued in 2012, when the USPSTF advised most men not to get screened for prostate cancer using an low-priced blood test, called a prostate specific antigen (PSA) test.

Newer research also has shown benefits from "active surveillance" of men whose initial PSA tests and biopsies indicate slow-growing cancer that hasn't spread, the panel said.

  • Aubrey Nash