Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The full report is titled “Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 17 July 2012 issue of Annals of Internal Medicine (volume 157, pages 120-134). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.
. Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2012;157:I-44. doi: 10.7326/0003-4819-157-2-201207170-00464
Download citation file:
Published: Ann Intern Med. 2012;157(2):I-44.
The U.S. Preventive Services Task Force (USPSTF), which is a group of health experts that makes recommendations about preventive health care.
The prostate is an organ in men that surrounds the tube that empties urine from the bladder. Prostate cancer is the most commonly diagnosed non–skin cancer among men in the United States. The most common prostate cancer symptoms are difficult or frequent urination, but many men have no symptoms.
A blood test that measures prostate-specific antigen (PSA) levels can find prostate cancer before symptoms develop. If the PSA level is high, a prostate biopsy may be needed to see whether cancer is actually present. During biopsy, doctors insert a hollow needle into the prostate to obtain a piece of the prostate to examine under a microscope.
At present, there is no way to tell with certainty which cases of prostate cancer are life-threatening and require treatment, and which cases are not. Most prostate cancer grows very slowly, and many men with prostate cancer die of something other than prostate cancer. However, screening puts men at risk for unnecessary worry and adverse effects of treatment with surgery, hormones, or radiation therapy.
In 2008, the USPSTF recommended that men older than 75 years of age not get PSA-based screening and concluded that there was not enough information to make a recommendation for younger men. It wanted to update that recommendation by reviewing studies that have become available since 2008.
The USPSTF reviewed published research to measure the benefits and harms of screening for prostate cancer with PSA testing.
Good evidence shows that PSA-based screening prevents only 0 to 1 prostate cancer death for every 1000 men screened. No studies show any benefit in overall death rates.
Good evidence shows that PSA-based screening can cause harms, including pain and complications from prostate biopsy and worry about test results. However, the more worrisome harms are related to treatment of prostate cancer found by screening when most of these cases, if not detected by screening, would never have caused problems for the patient. The side effects of prostate cancer treatments include sexual dysfunction, bowel and bladder incontinence, and even death.
For men of any age, the USPSTF recommends that doctors and patients do not screen for prostate cancer because the potential benefits do not outweigh the harms. However, the USPSTF realizes that some men may continue requesting the PSA test and some physicians may continue offering it. The decision to start or continue screening should be an informed one that reflects an understanding of the possible benefits and harms and should respect an individual man's preferences.
These recommendations apply to men of all ages. They do not include the use of the PSA test for monitoring after a diagnosis of prostate cancer or after treatment of prostate cancer. The recommendations may change as new studies become available.
This article was published at www.annals.org on 22 May 2012.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Hematology/Oncology, Prostate Cancer, Cancer Screening/Prevention, Prevention/Screening.
Results provided by:
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only