USPSTF Drafts Prostate CA Screening Recommendations

The potential harms of screening include false-positive results, additional testing, and years of additional close monitoring
The potential harms of screening include false-positive results, additional testing, and years of additional close monitoring

The U.S. Preventive Services Task Force (USPSTF) has published a draft recommendation statement and 3 evidence reviews on screening for prostate cancer. 

The statement serves to guide clinicians and patients in decision making about screening for prostate cancer. These recommendations apply to male adults who have not been previously diagnosed with prostate cancer and have no signs or symptoms of the disease, and to male adults with average or increased risk for prostate cancer (eg, African-American, family history of prostate cancer).

The USPSTF performed a systematic review of the existing evidence and concluded that the potential benefits and harms of prostate-specific antigen (PSA)-based screening are "closely balanced" in men aged 55-69 years and that it should be an individual decision whether to undergo screening or not (C Recommendation). For men aged ≥70 years, the USPSTF recommended no screening for prostate cancer as the potential benefits of PSA-based screening do not outweigh the harms (D Recommendation). 

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The benefits of screening include reducing the risk of death from prostate cancer and reducing the risk of metastatic cancer. The potential harms of screening include frequent false-positive results, which can result in immediate, additional testing, and years of additional close monitoring with repeated blood tests and biopsies. Some of the harms associated with treatment may include sexual impotence and urinary incontinence. 

Clinicians are recommended to discuss with patients who have a family history of prostate cancer—especially those with a father or brother diagnosed with prostate cancer—about the higher risk of developing the disease. 

Alex H. Krist, MD, MPH, member of the Task Force added, "In the end, men who are considering screening deserve to be aware of what the science says, so they can make the best choice for themselves, together with their doctor." More studies on the potential benefits vs. harms of screening for prostate cancer are needed among men with a family history of prostate cancer. 

The draft recommendation and evidence reviews are posted for public comment for consideration in the final recommendation and evidence review. 

For more information visit screeningforprostatecancer.org.