Navigation Links
New Prostate Cancer Screening Guidelines Unveiled
Date:3/3/2010

American Cancer Society now suggests those with PSA of less than 2.5 be tested every two years

WEDNESDAY, March 3 (HealthDay News) -- For the first time in almost a decade, the American Cancer Society has revamped its recommendations for prostate cancer screening.

In new guidelines released Wednesday, annual screening is now recommended for men whose prostate-specific antigen, or PSA, level is 2.5 nanograms per milliliter (ng/mL) or higher, but only once every two years for men whose PSA is under that threshold. Men with a PSA level of 4.0 ng/mL or higher should consider getting further evaluation, such as a biopsy. Previous guidelines had suggested that men with a PSA of less than 4.0 ng/mL should be screened annually.

"In the U.S., that I'm aware of, this is the first cancer organization that has recommended screening less often than a year in guidelines," said Kathryn Taylor, an associate professor of oncology at Georgetown University Lombardi Comprehensive Cancer Center in Washington, D.C.

The new guidelines also included specific suggestions on how to encourage shared decision-making such as the use of decision aids, many of which already exist, and specific topics to be discussed. As before, men should start talking about the possibility of screening with their health-care provider at the age of 50 if they are at average risk, and earlier if they are at higher risk.

"We continue to emphasize the importance of informed decision-making, and in this guideline we take it a step further," said Dr. Durado Brooks, director of prostate and colorectal cancer for the American Cancer Society. "For a long time, we have given some very general information about what men should be told. Here we have spent a great deal of time, energy and effort identifying the truly important core elements of that informed decision conversation so men really understand what the uncertainties and questions are surrounding this very complicated issue."

The American Cancer Society had been moving towards a stronger focus on making sure men understand the complicated constellation of risks and benefits of both PSA testing and digital rectal exams (DREs) since at least 1997, he added. These guidelines also downplay DREs, saying that when screening is performed, it can be done with PSA tests with or without the DRE.

"I don't think there's ever been as much depth and focus in really educating men and helping them make a good decision for themselves as to whether to have a PSA test," said Dr. Michael Barry, president of the Foundation for Informed Medical Decision-Making and a professor of medicine at Harvard Medical School in Boston.

The PSA blood test has long been a matter of controversy as it can result in a high rate of overdiagnosis, leading to unnecessary treatment and lasting side effects such as impotence and incontinence.

Finalization of the guidelines hinged on the results of two long-awaited, randomized trials, the largest to look at the question of prostate cancer screening. Unfortunately, one trial, out of Europe, found about a 20 percent decreased risk of dying from prostate cancer among men who were screened while a U.S. trial found no difference in mortality.

"Everyone had hoped these studies would settle the question, that there was no benefit to PSA testing and we could skip it or there was a benefit and we could get about doing it," Barry said. "The truth is this is a pretty close call. There's a small chance of lowering the risk of dying from prostate cancer but you can pay for it."

The guidelines also came out firmly against community-based screening.

"They have an emphasis on the informed decision-making and on men's values, really highlighting that this is not a right or wrong decision, that men's values really need to play a central role," Taylor said. "Putting this front and center was really a change."

The new guidelines are published online in advance of print publication in CA: A Cancer Journal for Clinicians.

Dr. Anton J. Bueschen, president of the American Urological Association (AUA), said his group concurs that "informed consent - including a discussion between physician and patient about the risks and benefits of testing - is a key part of one's decision to be tested for prostate cancer. It is equally necessary that patients receive reliable information from culturally appropriate sources.

"However," he added in a news release, "the new ACS statement may not fully characterize the potential benefits of an individualized approach to assessing risk in men considering the risk and benefits of early detection strategies and may cause significant confusion for patients. The AUA feels there is no single PSA standard that applies to all men, nor should there be. Part of 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."

More information

Learn more about prostate cancer at the American Cancer Society.



SOURCES: Durado Brooks, M.D., director, prostate and colorectal cancer, American Cancer Society, Atlanta; Kathryn Taylor, Ph.D., associate professor, oncology, Georgetown University Lombardi Comprehensive Cancer Center, Washington, D.C.; Michael Barry, M.D., president, Foundation for Informed Medical Decision-Making, and professor, medicine, Harvard Medical School, Boston; March 3, 2010, news release, American Urological Association; March 3, 2010, CA: A Cancer Journal for Clinicians


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Conventional prognostic factors fail to explain better prostate cancer survival in most Asian men
2. First biomarker discovered that predicts prostate cancer outcome
3. Frequent Prostate Screens Fail to Improve Aggressive Cancer Diagnoses
4. New male sling procedure helps prostate cancer survivors who suffer from urinary incontinence
5. Us TOO Launches National SEA Blue Campaign for Prostate Cancer Awareness Month
6. Red wine compound shown to prevent prostate cancer
7. Barbershop Talks Cut Black Mens Prostate Cancer Risk
8. Generic prostate drug helps find high-risk cancers early
9. Finasteride unlikely to induce high grade prostate cancers
10. Shrinkage of prostate led to overestimation of cancer risk in trial
11. Prostate Cancer Awareness Week to Screen Thousands
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... 13, 2017 , ... Dickinson Insurance and Financial Services, a ... services, is providing an update on a charitable event that began earlier this ... a locally recognized nonprofit that provides shelter and care for animals seeking new ...
(Date:10/13/2017)... ... ... The American Board of Family Medicine's (ABFM) Board of Directors has selected ... Dr. James C. Puffer upon his retirement. Dr. Newton will serve in the position ... the end of 2018. Upon assuming the role of President and CEO on January ...
(Date:10/13/2017)... EDWARDSVILLE, Ill. (PRWEB) , ... ... ... University Edwardsville School of Pharmacy (SOP) alumni Hannah Randall, PharmD ‘17, and ... educated healthcare professionals on guideline updates for the primary prevention of cardiovascular ...
(Date:10/13/2017)... ... October 13, 2017 , ... Many families have long-term insurance that ... insurance companies have a waiver for care if the client has a cognitive impairment ... family pays for care, is often waived, so the benefits from their insurance start ...
(Date:10/13/2017)... NJ (PRWEB) , ... October 13, 2017 , ... Global ... at scenic Alexandria Park in Milford, NJ. This free event, sponsored by Global ... physical activity. The fun run is geared towards children of all ages; it ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... 2, 2017  Eli Lilly and Company (NYSE: ... the third quarter of 2017 on Tuesday, October 24, ... that day with the investment community and media to ... conference call will begin at 9 a.m. Eastern time. ... live webcast of the conference call through a link ...
(Date:10/2/2017)... PHILADELPHIA , Oct. 2, 2017 Halo Labs announces ... particle analysis system called the HORIZON at MIBio 2017 in ... analyzes subvisible and visible particulate matter in biopharmaceutical samples with unprecedented ... use of the novel technique Backgrounded Membrane Imaging. ... The HORIZON subvisible particle analysis system ...
(Date:9/28/2017)... Hill-Rom Holdings, Inc. (NYSE: HRC), will host ... webcast on Friday, November 3, 2017, beginning at 7:00 ... approximately 8:30 a.m. (CDT) / 9:30 a.m. (EDT). ... performance and guidance for 2018, Hill-Rom executives will also ... performance, and long-range financial outlook through 2020. ...
Breaking Medicine Technology: