Prostate cancer tests are now OK with US panel, with caveats

But while some groups still recommend regular PSA tests, many have tempered their views.

A health panel with the USA government has decided that routine prostate cancer screenings can be done as long as the patient decides whether they want to or not after discussing it with their doctor. The new guideline says that for men between age 55 and 69, PSA testing can take place after the shared decision making conversation about pros and cons.

The panels says its latest recommendation is based on new evidence indicating that routine PSA blood tests can slightly reduce some men's chances of dying from prostate cancer.

In this photo taken Friday, April 7, 2017, Dr. Kirsten Bibbins-Domingo poses in her office in San Francisco. "The newer recommendation should empower men to be proactive about learning about the benefits and risks of screening and not avoid asking about it because their personal physician is not a believer in screening and never even broaches the subject; men should ask for the facts and not be shy about asking to have a PSA ordered if they feel it's in their interest to do so".

The proposal, which isn't yet final, pending input from the public, comes five years after the task force surprised many men and their doctors by recommending against the routine use of the commonly used blood test.

The draft of the guidelines signals a major shift in prostate screening advice for men, which in 2012 discouraged testing for healthy men of any age. The latest data show that over 180,000 men were diagnosed with prostate cancer in 2016, but there were only 26,000 deaths from it. Prostate cancer accounted for 4.4 percent of all cancer deaths in the United States past year.

"PSA screening saves lives", he says.

"The USPSTF recommends individualized decisionmaking about screening for prostate cancer after discussion with a clinician, so that each man has an opportunity to understand the potential benefits and harms of screening and to incorporate his values and preferences into his decision", the statement concludes.

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Most prostate cancers "are snails or slugs or tortoises", Hu said.

Specifically, the European Randomized Study of Screening for Prostate Cancer (ERSPC) found PSA testing cuts the chances of developing advanced prostate cancer by about 30 percent and the risk of dying from the disease by about 20 percent. Men who were diagnosed with prostate cancer were rushed to treatment with surgery, radiation or hormones.

"It's not like doing less screening only cut back on over-diagnosis and over-treatment of low risk cancer", Davis told Reuters Health.

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. An elevated level can be due to cancer but also can reflect a benign condition such as an enlarged prostate.

The new guidelines bring the task force more in line with other groups - such as the American Urologic Association, the American College of Physicians, and the American Cancer Society - which have still encouraged patients and doctors to discuss the test.

"It basically leaves it to the discretion of the primary care doctor, or the urologist, of any individual who wants to consider PSA-based prostate cancer screening, to them and the patient that they see", St. Clair Hospital Urologist Dr. Shailen Sehgal said. The task force is taking public comments on it until May 8. Researchers are seeking a more accurate way to detect prostate cancer and agree on the need for technology to identify which early-stage tumors will grow to become deadly. The PSA test became available in the mid-1980s.

The new guidance stems from recent evidence of the benefits of screening, and from a movement among prostate specialists toward active surveillance.

  • Ismael Montgomery