Prostate cancer tests are now OK with key panel, but with caveats

Prostate cancer tests are now OK with key panel, but with caveats

It is not recommended that men ages 70 and up, including African American men and men with a family history of prostate cancer, undergo screening for prostate cancer. From that, you can put a man into one of three groups: a low-risk group (he doesn't need PSA testing for another five years or so), an intermediate-risk group (he should get PSA testing in another year or two), and a high-risk group (he should be evaluated more closely right away). This trial showed no benefit from screening but - thanks to data sharing - we know the trial wasn't ideal. Figuring out whether to get a PSA test is a complex decision, based upon a patient's risk and other health problems, plus how he feels about the comparative risks of cancer and treatment.

Indeed, the US Preventive Services Task Force is responding to increasing evidence of an improvement in pathological interpretation, which allows for better prediction of the cancers that do not need treatment.

But, today, that panel reversed course, saying that men 55 to 69 should consider the test, but that men 70 and over should still skip it. The upgrading from the "D" rating in 2012 is based partly on recent scientific evidence that increased the USPSTF's certainty about reduced chances of PCa metastases and deaths.

A number of celebrities and politicians have become advocates of PSA testing after being diagnosed, Brawley said, raising awareness and fueling what he described as a "screening frenzy" that was also driven by early research, health fairs and doctors themselves.

A 2015 study concluded that avoiding treatment of low-grade prostate cancer in Americans who would never die from the disease would save $1.32 billion per year.

For high-risk patients, doctors will continue to recommend early screening starting at about age 40. This is in part because high levels of PSA often spur more invasive steps. If the cancer grows and becomes a threat, then the patient can opt for surgery. When a man has an elevated PSA, it may be caused by prostate cancer, but it could also be caused by other conditions, such as an enlarged prostate or an inflammation of the prostate.

"We have to work based on solid evidence that is in the medical literature and make a decision based on the balance of benefits and harms", Krist said. In fact, almost a decade ago the same group argue that there was little evidence that the PSA test helped younger individuals and men older than 75 years old should not be screened.

Dr. Anne Wallace, director of the Comprehensive Breast Health Center at UC San Diego Health, said that it doesn't surprise her that most doctors are not asking their patients to delay mammograms until they turn 50.

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Larry Blumberg's life changed when his doctor diagnosed prostate cancer past year. He said PSA tests make sense if they do not lead to overly aggressive treatment. But many men can live with the disease for years without its causing serious illness. For at-risk men, including men who are African-American, have a family history of prostate cancer, family history of breast cancer or the BRCA gene, and those who have been exposed to certain chemicals like fireman and veterans, as well as men over the age of 65 further assessment, is required. The Task Force has developed answers to frequently asked questions, a fact sheet, and infographic to help clarify the draft recommendations.

"As a patient, you don't want to panic about a screening test", said Vapiwala. So I use the analogy reluctantly, hesitantly, and only because I think it helps us think more clearly about screening.

The potential benefit is reducing the chance of dying of prostate cancer, though that chance is small. Read the new advice here.

For men between the ages of 55 and 69, getting screened for prostate cancer is a mixed bag of possible, down-the-road benefits and just-as-possible immediate harms.

The revised draft recommendation is open to public comment before a final recommendation is issued.

"The importance of PSA testing is that it's bringing men into contact with the healthcare system", said Dr. Ramon Perez, an urologist and advisor to MHN.

Even upon diagnosis, the difference between an aggressive prostate cancer that could kill and one that might languish harmlessly for decades is often unclear to physicians.

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