The U.S. Preventive Services Task Force (USPSTF) recently released recommendations regarding prostate cancer testing by way of the Prostate Specific Antigen (PSA) blood test in their report titled “Screening for Prostate Cancer: A Review of the Evidence for the U.S Preventive Services Task Force”. Click here to read the full report.
The USPSTF concluded “Prostate-specific antigen–based screening results in small or no reduction in prostate cancer–specific mortality and is associated with harms related to subsequent evaluation and treatments, some of which may be unnecessary”. Put simply, the USPSTF believe that PSA blood tests do more harm than good and the PSA’s use in testing men for prostate cancer should be abandoned.
The U.S task force did however go on to say that “clinicians should discuss the potential benefits and known harms of PSA screening with their patients younger than age 75 years. Men in this age group should be informed of the gaps in the evidence, and their personal preferences should guide the decision of whether to order the test”.
Despite the task force’s recommendations, there are multiple concerns surrounding the way in which these conclusions were reached. These include but are not limited to the fact that neither one prostate cancer specialist nor oncologist was part of the task force or were asked their specialist opinion on the topic and the recommendations were based on a fundamentally flawed research study that failed to show any mortality benefits of prostate cancer screening.
Of concern, the most recent data from one of the most significant prostate cancer screening trials, known as the European Randomized Study of Screening for Prostate Cancer (ERSPC) published in March 2012 that found after following up 182,000 men that prostate cancer testing can reduce the death rate of men from prostate cancer by up to 38%.
As such numerous peak prostate and urological bodies in Australia including Prostate Cancer Foundation of Australia (PCFA) and the Urological Society of Australia and New Zealand (USANZ) are quoted as saying the USPSTF recommendations are ‘unhelpful’ and are not based on the correct interpretation of the evidence. Prostate Screen Australia continues to advocate the availability of informed Prostate Cancer Testing for men aged between 40 – 70 years by way of a PSA blood test and physical examination.
At Prostate Screen Australia, Australia’s only prostate cancer testing group, the foundation of consultation is based upon a shared decision making framework between our doctors and each individual patient. Patients are educated prostate cancer, the risks and benefits of testing and are then provided with the choice if they wish to proceed with testing.
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