Federal US PSTF Task Force is updating its recommendation against PSA screening
From AdMeTech Foundation – November 3, 2015
The U.S. Preventive Services Task Force (USPSTF) announced on October 29, 2015 that it will re-evaluate and update its recommendation against PSA screening for prostate cancer made in 2011-2012. Read more
In October 2011, AdMeTech Foundation expressed concerns about these guidelines and submitted a public response: https://www.admetech.org/us-preventive-services-task-force-us-pstf/
Like any other medical tests, PSA screening is not perfect and it is associated with not only benefits, but also risks. PSA cannot distinguish lethal prostate cancer from benign diseases and low risk (“harmless”) malignancies, which are not likely to cause symptoms in a man’s lifetime. However, it is the best option men have today for early detection, which is critical for saving lives. Introduction of PSA testing and its large-scale clinical use since 1990 played a significant role in the drastic reduction of prostate cancer mortality (by over 47% by 2011) (1).
Unfortunately, US PSTF did not recognize this profound impact on mortality, and recommendations against PSA testing were made irrespectively of an individual man’s of prostate cancer. These recommendations caused headlines in the major media across the nation and made a direct and immediate impact on men’s compliance with screening. According to the American Cancer Society, compliance with PSA screening has decreased by 16% in 2013 for all men compared to 2010, with the largest reduction (23%) seen in younger men (aged 50 to 64) who need it the most (2).
Only a few months ago, a clinical study (published in the Journal of Urology) demonstrated that within one year after the guidelines were issued, there was a delay in the diagnosis of aggressive prostate cancer in a significant number of men (over 23%) (3). Unfortunately, this data reflected predictions of the leaders of the expert community, who repeatedly expressed their concerns that the US PSTF recommendations have left men without any other alternatives for detection of prostate cancer at early stages, when cure is more likely.
Since 2011, we have seen a rapidly growing evidence and related strategies for reducing the risks and increasing the benefits of PSA screening. Over the last several years, we have seen emergence of novel, groundbreaking advances in diagnosis and treatment, highlighting the importance of screening and reducing over-diagnosis and over-treatment even further.
Thus, we are pleased that US PSTF responded to these exciting advances by announcing its intention to re-evaluate recommendations against PSA screening and inviting public comments from October 29, 2015 to November 26, 2015.
If you are interested in reviewing the draft plan and submitting your personal perspective, please visit here
References:
- National Cancer Institute SEER database.
- American Cancer Society’s report on Cancer Prevention and Early Detection of 2015 and 2014 (for 2013 and 2010, respectively).
- Barocas, D., Mallin, K., Graves, A., et. al. Effect of the USPSTF Grade D Recommendation against Screening for Prostate Cancer on Incident Prostate Cancer Diagnoses in the United States, Journal of Urology 2015, Vol. 194 pp. 1587-1593 (online): http://www.jurology.com/article/S0022-5347%2815%2904209-3/pdf
