New guidelines from the American Urological Association now say men under 55 do not need routine annual prostate screening.
According to new guidelines released Friday by the American Urological Association (AUA), “healthy men under 55 don’t need routine annual screening. And men ages 55 to 69 who are considering the PSA should consult their doctors about the test’s benefits and risks.” According to Dr. H. Ballentine Carter, who chaired the panel that designed the new guidelines, they “learned very quickly that there really was no high-level evidence supporting the use of screening with PSA.” However, Dr. Carter, who is also a professor at Johns Hopkins University School of Medicine in Baltimore, acknowledged that many men and their doctors may be slow to accept these new guidelines. He said, “The public is very enthusiastic about screening, partly because of our messaging. The idea that screening delivers benefits may have been over-exaggerated.”
This new stance by the AUA, which has “staunchly defended the PSA screening test in recent years,” is more in line with both the American Cancer Society and at least five other medical groups, all of which advocate strongly for “shared decision-making,” between doctor’s and their patients. Three separate medical groups, including the US Preventive Services Task Force go even further and have advised men to skip the PSA screening altogether.
According to Dr. Carter, these new guidelines have been based, “strictly on medical evidence from rigorously designed clinical trials,” and the urologists who wrote them “considered the same evidence” that prompted the US Preventive Services Task Force to make their own recommendation. The panel also followed the guidelines set out by the Institute of Medicine for making health recommendations. After all of the data was evaluated, Carter said, “The evidence for the benefits of prostate cancer screening was moderate, but the quality of evidence on the harms was high.” The AUA report shows:
Evidence suggests that screening with PSA tests is tied to a small reduction in deaths – about one per 1,000 men screened over a decade. But some results are also false-positives and spur unnecessary further testing and treatment, which can leave men impotent and incontinent.
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Of course the AUA cautions that “men with prostate pain or other problems should still talk to their doctors about their symptoms.” And Dr. Carter added that younger men who are considered “at high risk” for prostate cancer should talk to their doctor. He said:
Men at higher risk include African Americans and those with a very strong family history of prostate cancer, defined as cancer that develops before age 50, in multiple first-degree relatives, such as fathers or brothers.
Dr. Michael Palese, Associate Professor of Urology at the Icahn School of Medicine at Mount Sinai, said the new guidelines are a “radical” but welcome change. He said, “It will help to change the current climate of over-biopsy and overreaction when it comes to PSA. On the other hand, we do need to continue to keep a vigilant watch on those patients who have prostate cancer that should be treated and will benefit from treatment.”
Photo: AP/Steve Earley
I’m not surprised. When it comes to men, there seems to be a tendency to deny them health care. You’d think a penis made one immune from disease. You’d hope that men dying an average of five years earlier would generate some concern.
“You’d think a penis made one immune from disease. ”
Why do you think circumcision exists? Clearly it’s to stop men becoming immortal. 😛
Yes, like Samson’s hair, except for the blonde part
I guess if it saves one life, it’s no good enough.
“Evidence suggests that screening with PSA tests is tied to a small reduction in deaths – about one per 1,000 men screened over a decade.” …. says it all.