Academic Urology Comments on Prostate Screening Recommendations

Recently, the US Preventive Services Task Force (USPSTF) made its final recommendations on the use of the prostate-specific antigen (PSA) test to diagnose prostate cancer. In the opinion of the Task Force, the PSA test should not be performed on men who otherwise have no symptoms of prostate disease. The Task Force cited a range of factors in its recommendations, including the number of “false positive” results, the potential risks of prostate biopsies, as well as the risks and complications of surgery or radiation if cancer is detected.

In the view of Academic Urology and other urologists, however, the USPSTF report has a number of serious flaws. For example, the Task Force:

  • Did not include any urologists or oncologists, the physicians most expert in the diagnosis and treatment of prostate cancer;
  • Did not include recent survey results from Europe that demonstrated a 21% survival advantage with PSA testing; and
  • Neglected to note that death rates from prostate cancer have declined by almost 40 percent in the last twenty years in the United States (since PSA testing has become widespread), even as the incidence of the disease has remained stable.

The PSA test is a powerful tool to help your doctor determine if you have cancer. It is not a perfect test, and your urologist will use a range of additional diagnostic tools and techniques to determine if an elevated PSA score is being caused by prostate cancer. Once a diagnosis is made, you and your urologist need to discuss all the treatment options, along with their potential risks and benefits. In some cases, the best course of action is simply continued monitoring. This is a decision to be made by you in consultation with your doctor.

Academic Urology does not believe a blanket recommendation against PSA screening tests makes sense, and we support its continued use as one of many tools for the diagnosis and management of prostate disease. This is especially true for men with other risk factors, such as ethnic heritage or family history. This opinion is based upon the most recent science, as well as our experience caring for thousands of men. You can read more about these issues at the web site for the American Urologic Association. 

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