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AUA Responds to American Cancer Society Guideline for the Early Detection of Prostate Cancer
Date:3/3/2010

f informed consent is giving patients as much information about their personal risk as is available. Applying population-based cut points while ignoring other individual risk factors (such as age, ethnicity, family history, previous biopsy characteristics, etc.) may not give a patient the most optimal assessment of his risk, including the risk of high grade disease.

Prostate cancer testing is an individual decision that patients should make together with their doctor. The AUA believes that all men, with a life expectancy of 10 years or more, should have a baseline PSA test at the age of 40. Physicians should determine rescreening intervals for each patient based on PSA (and, on occasion on its change over time). Likewise, the decision to proceed to prostate biopsy should be based not only on elevated PSA and/or abnormal DRE results, but should take into account multiple factors including free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity, prior biopsy history and comorbidities. Although prostate cancer risk correlates with serum PSA, there is no PSA value below which a man may be reassured that he does not have biopsy detectable prostate cancer.

The AUA is in full agreement with the ACS that current early detection strategies need to be refined and better validated.  It is hoped that new biomarkers will be identified which better distinguish between indolent and aggressive prostate cancer, sparing the former from unnecessary testing and giving the latter a better chance of survival."


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SOURCE American Urological Association
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