The best evidence of benefit from PSA screening was among men aged 55 to 69 screened every two to four years. In this group, PSA testing was found to prevent one death a decade for every 1,000 men screened. But this benefit could be much greater over a lifetime, the guidelines noted.
The guidelines also said PSA screening could benefit men in other age groups who are at higher risk of prostate cancer due to factors such as race and family history. These men should discuss their risk with a doctor and assess the benefits and potential harms of PSA testing.
The new guideline updates the AUA's 2009 Best Practice Statement on Prostate-Specific Antigen and was announced at the association's annual meeting in San Diego on Friday.
"There is general agreement that early detection, including prostate-specific antigen screening, has played a part in decreasing mortality from prostate cancer," Dr. H. Ballentine Carter, who chaired the panel that developed the guidelines, said in an AUA news release.
There is more and better data about PSA screening available today than there was in 2009, so it is "time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms," Carter said.
One expert said the revised guidelines made sense.
"I think these guidelines are quite appropriate given the [slow-growing] nature of many prostate cancers," said Dr. Erik Goluboff, an attending urologist in the department of urologic oncology at Beth Israel Medical Center in New York City.
He agreed that discussions between a patient and his doctor on the PSA test are "extremely important."
"It has become increasingly evident that many, if not most, men diagnosed with early prostate cancer will never need treatment and can be spared the potentially devastating side effects of treatment such as urinary incontinence and erectile dysfunction," Goluboff said.
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