USPSTF Recommends Patient Choice for Prostate Cancer Screening

In its final recommendation, the US Preventive Services Task Force (USPSTF) recommends that men aged 55 to 69 make their own decision on whether to be screened periodically for prostate cancer after they have had a conversation with their physician on potential benefits and harms.

The recommendation means more men could be screened, now that the recommendation has been upgraded from its existing D recommendation to a grade C recommendation. In 2012, the task force recommended against prostate-specific antigen (PSA)-based screening for prostate cancer.

For men aged 70 and older, the potential benefits do not outweigh the harms, and they should not be routinely screened, according to the final recommendation, which is in accordance with the 2012 statement.

USPSTF’s statement emphasized the importance of shared-decision making between patients and physicians. “That several guidelines now recommend a shared decision making approach for prostate cancer screening is a strong indication that, for this decision, the available data do not allow the physician to recommend a course of action without further understanding what is important to the patients—which can only happen by spending time in discussion,” according to the statement.

The task force recommends that the conversation initially be focused on the patient understanding that the screening is a choice, and then the decision to screen should be based both on current understanding of risks and benefits of screenings as well as how the individual patient values those risks and benefits. For African American men and those with a family history of the disease, the task force urged physicians to inform them of their higher risk of developing prostate cancer.

Organizations have praised the task force for its update on PSA-based screening recommendation. The American Urological Association released a statement commending the task force for the update, noting that it is in alignment with their guidelines as well as guidelines from other major physician groups, including the American Cancer Society, the American College of Physicians, and the American Society of Clinical Oncology.

Reference:

Misra-Herbert A, Kattan M. Prostate cancer screening—a new recommendation for meaningful physician-patient conversations. JAMA Oncol. [published online May8, 2018]. doi:10.1001/jamaoncol.2018.1492.