Ned Calonge, MD, MPH; Diana B. Petitti, MD, MPH; Kenneth W. Lin, MD
Potential Financial Conflicts of Interest: None disclosed.
Calonge N, Petitti DB, Lin KW. Are Age-Based Criteria the Best Way to Determine Eligibility for Prostate Cancer Screening?. Ann Intern Med. 2009;150:221-222. doi: 10.7326/0003-4819-150-3-200902030-00020
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Published: Ann Intern Med. 2009;150(3):221-222.
We appreciate the letters from Drs. Konety and colleagues and Dr. Gogol regarding the USPSTF's updated recommendation on screening for prostate cancer (1). The USPSTF recommended against screening men age 75 years or older.
First, it is important to emphasize that a systematic review conducted in collaboration with the USPSTF (2) identified no direct evidence (that is, evidence from randomized trials) that permitted the USPSTF to determine whether prostate-specific antigen screening has a net benefit on mortality for men of any age. Although some men may benefit from earlier detection of potentially fatal cases of prostate cancer, others will be harmed by the adverse effects of detection and treatment of seemingly abnormal prostate cells that would never have caused clinical symptoms. We will not know whether the uncontrolled experiment that began in the early 1990s of screening millions of men for prostate cancer has, on the whole, increased or shortened life expectancy until ongoing randomized trials are completed.
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