New recommendations for prostate cancer screening
The United States Preventive Services Task Force (USPSTF) has changed its recommendation for prostate cancer screening, specifically related to the blood test that measures prostate-specific antigen, or PSA, which can indicate a growing cancer.
Prostate cancer is diagnosed in about 180,000 men every year and leads to roughly 26,000 deaths annually. But many men can live with the disease for years without it causing serious illness.
The task force, a panel of experts supported by the US Department of Health and Human Services' Agency for Healthcare Research and Quality, this week is advising men between the ages of 55 and 69 to start a conversation with their doctors about whether to have a PSA test, based on each patient's personal values and priorities.
While a PSA test itself isn't invasive it requires drawing blood experts are concerned that patients may end up undergoing invasive procedures despite having little chance of developing an aggressive cancer.
The group continues to recommend against PSA testing for men 70 and older because the harm can outweigh any benefits.
Many men who have high PSA levels undergo a biopsy, which provides vital insight into whether a man has cancer but can't predict how aggressive it might be. 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 new recommendations may help patients get personalised care to address their health and specific concerns.
Additionally, prostate cancer in many patients may not result in dangerous complications. Many people may not even be aware they have the disease.
Prostate cancer is so common that one published 2015 study reported more than one-third of white men and one-half of black men ages 70 to 79 were found to have previously undiagnosed prostate cancer on autopsy.
The new guidance stems from recent evidence of the benefits of screening, and from a movement among prostate specialists towards active surveillance. In this approach, doctors keep a close eye on men with a high risk of prostate cancer, rather than treating outright.