May 4, 2013
American Urological Association Releases New Prostate Cancer Screening Guidelines
redOrbit Staff & Wire Reports - Your Universe Online
Healthy men under the age of 55 do not need routine annual prostate cancer screenings, according to new clinical practice guidelines released by the American Urological Association (AUA).
The agency, which USA Today reporter Liz Szabo said “staunchly defended” prostate-specific antigen (PSA) screenings in recent years, has now declared the tests are “not recommended” for anyone under the age of 40, for average-risk men between the ages of 40 and 54, and for anyone over age 70 or with a remaining life expectancy of between 10 and 15 years, the organization noted.
For males between the ages of 55 and 69, the decision to undergo PSA screening should be made after consulting with doctors about the potential risks and benefits of the procedures, the AUA said in a statement. Men in that age group should carefully weigh “the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the known potential harms associated with screening and treatment.”
In order to deduce the possible risks associated with the screenings, a routine interval of at least two years “may be preferred” over annual screenings in men who have opted to undergo PSA tests, the AUA said. They expect the extended amount of time between tests could maintain the majority of the testing´s benefits while also reducing over-diagnosis of the disease and helping to limit false positives.
The new guidelines update the AUA´s 2009 Best Practice Statement on Prostate-Specific Antigen (PSA) and was announced during the organization´s annual meeting in San Diego, California. It does not specifically address the detection of prostate cancer in symptomatic men, in which those symptoms could be linked to locally advanced or metastatic prostate cancer, they explained
“The new guideline is significantly different than previous guidance inasmuch as it was developed using evidence from a systematic literature review rather than consensus opinion; provides rating and interpretation of the evidence based on randomized controlled trials with modeled and population data as supporting evidence; and develops statements that do not go beyond the available evidence,” the AUA said.
“There is general agreement that early detection, including prostate-specific antigen screening, has played a part in decreasing mortality from prostate cancer,” added Dr. H. Ballentine Carter, chairman of the panel that developed the new guidelines. “It´s time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms“¦ The best available evidence suggests that following these guidelines will lead to an improved benefit-to-harm ratio.”
According to MedPage Today staff writer Charles Bankhead, the review included an analysis of PSA-related literature published between 1995 and 2013, and focused on four age-defined patient groups (under 40, 40 to 54, 55 to 69 and 70 and over). The AUA panel specifically looked at the efficacy of PSA screening for early prostate cancer diagnosis with the goal of reducing prostate cancer related mortality rates, he added.