Since 2012, the United States Preventive Task Force (USPSTF) has recommended against prostate cancer screening, but the task force recently shifted their view and now encourages some men from ages 44 to 69 to talk about screening with their doctors. The USPSTF, however, still maintains that men 70 and older should not be screened for prostate cancer, according to a draft document released earlier this week.
Prostate cancer is one of the most common cancers, with more than 180,000 being diagnosed in the U.S. each year. A screening blood test evaluates the amount of prostate-specific antigen (PSA). While having an elevated PSA does not necessarily mean a man has prostate cancer, it can lead to further testing that could result in a biopsy or diagnosis.
New studies and a shift in how low-risk prostate cancer is treated are the primary reasons behind the task force’s change. Since 2012 when the original recommendations were published, active surveillance has become a standard treatment option for those with slower-growing prostate cancers. This means a patient is followed closely to ensure the cancer doesn’t spread, but they do not receive any treatment such as surgery or radiation therapy. This can help men avoid side effects that impact quality of life, such as reduced urinary or sexual function, for a disease that likely would have progressed very slowly and not caused death.
Edward M. Messing, M.D., F.A.C.S., Winfield W. Scott Professor and Chair of the Department of Urology at UR Medicine, and a past president of the American Urological Association (AUA), said the USPSTF has taken a step in the right direction. Messing, who has conducted research on prostate cancer screening, also said:
- All men should have a conversation with their doctors when it comes to prostate screening. This is especially important for African-American men and/or men with a family history, both of whom have a higher risk of dying from the disease.
- He disagrees with the USPSTF that no man after age 70 should be screened. In fact, the USPSTF draft document states that more than two-thirds of those who die from prostate cancer are age 75 or older.
- A personalized approach is needed for older men, based on their health status. For example, although screening might not be appropriate for men over 70 who have other life-threatening health issues such as heart failure, healthy men in their 70s who can expect to live another 15 years should consider getting screened.
“The major thing is that this should be a discussion,” Messing said. “There are many tradeoffs and all men and their physicians should talk about them.”
The public is invited to comment on the draft recommendations from now until May 8. To learn more, visit screeningforprostatecancer.org.