Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

USPSTF: Screening for Prostate Cancer

JAMA; 2018 May 8; Grossman, et al

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.

Citation:

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.

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