What to know about new advice on prostate cancer test

The task force made the recommendation, which is still in draft form as it seeks public comment, after determining that the potential benefits and harms of the prostate-specific antigen test are closely balanced in men ages 55 to 69.

An influential physician task force backed by the USA government is softening its opposition to routine prostate cancer screening.

The USPSTF did not change its recommendation against PSA-based screening for prostate cancer in men ages ≥70, finding that the potential benefits did not outweigh the potential harms.

The new recommendations come from the U.S. Preventive Services Task Force, a government-appointed volunteer panel of experts.

So if I opt for PSA screening I'm gambling that I'll be the 1 in 1,000?

The task force chose to adjust its screening recommendations based on new research.


"Increased communication between men and their medical providers will cause them to be more knowledgeable about their health and make more informed choices", said James Morning, advisor to MHN, Vietnam veteran, and a prostate cancer survivor. These recommendations apply to male adults who have not been previously diagnosed with prostate cancer and have no signs or symptoms of the disease, and to male adults with average or increased risk for prostate cancer (eg, African-American, family history of prostate cancer). An elevated level can be due to cancer but also can reflect a benign condition such as an enlarged prostate.

In the study, only about 1 percent of men died of prostate cancer over 10 years, with no significant differences between those who were treated and those who simply kept a watchful eye.

"There are some men who might say, 'You know, I really want to avoid dying of prostate cancer". The harms of screening include frequent false-positive results, which often lead to immediate, additional testing and years of additional close follow-up, including repeated blood tests and biopsies.

"Unfortunately, the C rating is still insufficient and risky for high-risk men or men who - without testing - will develop aggressive or advanced disease", said Bearse.

For men 70 and older, the advisory panel continues to recommend against PSA-based testing, arguing that for this age group, prostate cancer evolves slowly and the 10-year survival rate is relatively high.

"We've been jumping up and down about this for years and years", Dr. Benjamin Davies, an associate professor of urology at the University of Pittsburgh School of Medicine, told CNBC. The task force draft says screening conversations should begin at age 55.


For these men, the task force recommends withholding treatment and monitoring the cancer until it requires treatment.

More than 161,000 men in the United States will be diagnosed with prostate cancer in 2017, according to the cancer society, and nearly 27,000 men will die of the disease.

Dr. Kirsten Bibbins-Domingo, a San Francisco internist believes "this isn't a one-size-fits all" procedure. Treatment for prostate cancer, including removal of the prostate and radiation, is associated with incontinence and erectile dysfunction.

The task force's 2012 advice against screening said there was little evidence that PSA screening was reducing deaths. The final recommendation statement from the task force will be developed after the comment period closes. At the same time, the specialty group took issue with the panel's decision to maintain its recommendation against screening for men 70 and older, saying that healthier older men might benefit from the test. It is a highly respected, highly skilled group of public health experts who review scientific studies and make recommendations on disease prevention and screening. Some men who are concerned about prostate cancer will elect to be screened, and others who are less concerned will not; doctors should support either decision.

PSA-based screen and biopsies can not tell for sure which cancers are likely to be aggressive and spread or to grow so slowly as to never cause symptoms.



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