Prostate cancer tests are now OK with panel, with caveats

CHICAGO (AP) — An influential USA government advisory panel is dropping its opposition to routine prostate cancer screening in favor of letting men decide for themselves after talking with their doctor.

PCEC's council of experts believes that men should receive a baseline PSA blood test at age 40 to determine risk stratification, based on this assessment, PCEC recommends that men establish a testing follow up schedule with their doctor.

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.

Yet "the balance of benefits and harms is still close", said Kirsten Bibbins-Domingo, an internist at the University of California at San Francisco and task-force chair. Because radiation and surgery may lead to impotence, bowel injury and problems with urination, some men may be uncertain about what to do with a positive test result.

In addition, the task force noted, an increasing number of men with low-risk cancer are opting for "active surveillance", which involves regular PSA testing, repeated rectal examinations and biopsies rather than aggressive treatment.

The previous guideline, which was only a few years old, recommended against PSA testing in all age groups.

The USPTF issued the draft recommendations in April 2017 to solicit public comment.

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Nearly 240,000 new cases of prostate cancer are diagnosed each year.

Dr. Alex Krist, a member of the USPSTF task force and a family medicine doctor at Virginia Commonwealth University in Richmond, said a high PSA may not necessarily point to prostate cancer.

But the PSA test offers a small potential for benefit - with clear potential for harm. "It also decreased diagnosis of intermediate and high risk potentially lethal disease".

What should patients keep in mind when they go to the doctor? The latest research also suggests a small net benefit from screening, she says.

For more about prostate cancer, visit the American Cancer Society.

"Some men who are very concerned about prostate cancer will elect to be screened, and others who are less concerned will elect not to be screened; either decision should be supported", he wrote. Men who were diagnosed with prostate cancer were rushed to treatment with surgery, radiation or hormones. PSA levels become elevated in cases of cancer-but also benign prostate problems. U.S. Preventative Services Task Force.

Prostate cancer is one of the most common types among men in the USA; almost 13 percent will be diagnosed with it over the course of their lifetimes, according to the National Cancer Institute.

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The draft prostate cancer recommendations, announced online in the Journal of the American Medical Association, are open for public comment on the task force website until May 8.

That brings federal guidelines in step with recommendations from a state task force, released last week. And even if the test detects an actual malignancy, many prostate cancers grow so slowly that they never become life-threatening.

Prostate cancer is so common that one published 2015 study reported more than one-third of white men and one-half of black men ages 70 to 79 were found to have previously undiagnosed prostate cancer on autopsy. Medicare and many private insurers have continued to pay for the screening.

NY real estate executive Stephen Fredericks, 63, is a proponent of PSA testing.

The draft recommendation applies to adult men in the general USA population without symptoms or a previous diagnosis of prostate cancer as well as to men at increased risk of death from prostate cancer due to race or family history of prostate cancer, but provides additional information for those at increased risk.

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

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