Risa B. Burns, MD, MPH; Aria F. Olumi, MD; Douglas K. Owens, MD, MS; Gerald W. Smetana, MD
Disclaimer: Dr. Owens is a member of the USPSTF. The views expressed are his own and not necessarily those of the USPSTF, U.S. government, or Department of Veterans Affairs.
Acknowledgment: The authors thank the patient for sharing his story.
Grant Support: Beyond the Guidelines receives no external support.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-1072.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor, Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson, and Colgate-Palmolive. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.
Corresponding Author: Risa B. Burns, MD, MPH, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, E/Yamins 102, 330 Brookline Avenue, Boston, MA 02215; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Burns, Olumi, and Smetana: Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.
Dr. Owens: Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305.
Prostate cancer is the third most common cancer type in the United States overall, accounting for 9.5% of new cancer cases and 5% of cancer deaths. The goal of prostate-specific antigen (PSA)–based screening is to identify early-stage disease that can be treated successfully. The U.S. Preventive Services Task Force (USPSTF) reviewed evidence on the benefits and harms of PSA-based screening and treatment of screen-detected prostate cancer. It found that PSA-based screening in men aged 55 to 69 years prevents approximately 1.3 deaths from prostate cancer over 13 years per 1000 men screened and 3 cases of metastatic cancer per 1000 men screened, with no reduction in all-cause mortality. No benefit was found for PSA-based screening in men aged 70 years and older. On the basis of its review, the USPSTF concluded that the decision for men aged 55 to 69 years to have PSA-based screening should be an individual one and should include a discussion of the potential benefits and harms. Here, 2 experts—an internist and a urologist—discuss the key points of a shared decision-making conversation about PSA-based prostate cancer screening, the PSA-based screening strategy that optimizes benefit and minimizes harm, and the PSA threshold at which they would recommend further diagnostic testing.
Burns RB, Olumi AF, Owens DK, Smetana GW. Would You Recommend Prostate-Specific Antigen Screening for This Patient?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2019;170:770–778. doi: 10.7326/M19-1072
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Published: Ann Intern Med. 2019;170(11):770-778.
Cancer Screening/Prevention, Hematology/Oncology, Prevention/Screening, Prostate Cancer.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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