Clinicians should not screen men aged 55 to 69 years for prostate cancer who do not express a preference for screening, according to a new recommendation statement from the US Preventive Services Task Force (USPSTF). The statement, which updates the 2012 USPSTF recommendation on prostate-specific antigen (PSA)-based screening for prostate cancer, also recommends against PSA-based screening for prostate cancer in men aged ≥70 years. The recommendation states:
- For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)–based screening for prostate cancer should be an individual one.
- Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision.
- Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction.
- In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes.
- Clinicians should not screen men who do not express a preference for screening.
- The USPSTF recommends against PSA-screening for prostate cancer in men aged ≥70 years.
Grossman DC, USPSTF Task Force. Screening for Prostate Cancer. US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(18):1901-1913. doi:10.1001/jama.2018.3710.
This Week's Must Reads
Combination model predicts imminent preeclampsia, Ciobanu A et al. Am J Obstet Gynecol. 2019 Feb 7. doi. org/10.1016/j.ajog.2019.01.235
Delayed cord clamping didn’t drop maternal hemoglobin in term cesarean deliveries, Purisch S. et al. Am J Obstet Gynecol. 2019 Jan;220(1):S37-38, Abstract 47
Dental device borrowed from sports world no help in pushing, Bergh E et al. Am J Obstet Gynecol. 2019 Jan;220(1):S39, Abstract 49
Enterovirus in at-risk children associated with later celiac disease, Kahrs CR et al. BMJ. 2019 Feb 13. doi: 10.1136/bmj.l231
Must Reads in Clinical Guidelines
ACIP Updates Adult Immunization Schedule, Ann Intern Med; 2019 Feb 5; Kim, Hunter, et al
USPSTF: Interventions to Prevent Child Maltreatment, JAMA; 2018 Nov 27; US Preventive Services Task Force
Cholesterol Guidelines Stress Lifetime Approach, Circulation; ePub 2018 Nov 10; Grundy, et al
USPSTF: Screen Adults for Unhealthy Alcohol Use, JAMA; 2018 Nov 13; Curry, et al
Screening for Syphilis Infection in Pregnant Women, JAMA; 2018 Sep 4; US Preventive Services Task Force