USPSTF: Final Recommendation Statement on Prostate Cancer Screening

Men over 70 years of age should not be routinely screened
Men over 70 years of age should not be routinely screened

The US Preventive Services Task Force (USPSTF) has issued a final recommendation statement on screening patients for prostate cancer.

The Task Force recommends that for men 55 to 69 years of age, the decision to undergo prostate-specific antigen (PSA)-based screening for prostate cancer should be an individual one. 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 (C 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). 

"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," said Task Force vice chair Douglas K. Owens, MD, MS. "Men who place more value on avoiding the potential harms may choose not to be screened."

Findings from an evidence review conducted by the Task Force revealed that for men aged 55–69 years, 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.

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Responding to the USPSTF recommendations, the American Urological Association (AUA) said that the recommendation for individual decision-making for men 55 to 69 years of age was "in direct alignment with the AUA's clinical practice guidelines and guidelines from most other major physician groups." However, with regard to older patients (>70 years), the AUA stated that "select older, healthier men may garner a benefit" from PSA screening. These specific patients should speak with their clinicians about whether prostate cancer testing is appropriate for them. 

For more information visit JAMA.com.