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November 2011
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NCH Responds to Debate Over PSA Screening for Prostate Cancer

In October, the U.S. Preventive Services Task Force (USPSTF) released new draft recommendations against PSA-based (prostate-specific antigen) screening for prostate cancer. The announcement has stirred controversy and opposition from many groups in the medical community, including the American Urological Association and NCH’s own Prostate Advisory Board (PAB).

The proposed guidelines from the USPSTF assert there is "moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.” The independent panel pointed out that while an elevated PSA level can signal prostate cancer, it can also indicate benign conditions and lead to invasive biopsies. The panel added that the PSA test is not effective at distinguishing between aggressive and slow-growing cancers, contending it leads to over-treatment that is associated with potential harms.

In a statement issued to the community, the Hospital’s PAB acknowledges that while not all prostate cancers are life-threatening, successful treatment depends on early detection. The PAB confirms that there are currently no better tests than the PSA for detecting prostate cancer.

In fact, mortality from prostate cancer in the United States has decreased by 40 percent since 1994, which is when PSA testing became a widely used diagnostic tool. The European Randomized Study of Screening for Prostate Cancer recently reported a 20 percent reduction in prostate cancer mortality and a 41 percent decrease in metastatic disease in men ages 55 to 69 after a median follow-up time of nine years, compared to those who did not receive PSA screening.

To help physicians determine when men should be screened for prostate cancer, the PAB has issued a quick-reference PSA Guidelines card. Click here to view and download the Guidelines, which also indicate when patients should be referred to an urologist for follow-up care.

Physicians are encouraged to speak with men who are at risk for prostate cancer, and to review their medical history and known risk factors. Physicians should continue to consider a PSA blood test and digital rectal exam (DRE) as part of the patient’s annual health visit. Early prostate cancer does not cause specific symptoms and without screening, cancer is often detected at a fairly advanced stage, limiting options for cure.

For more information about PSA screening for prostate cancer, please call Juli Aistars, RN, APN, prostate nurse navigator, at 847.618.6572.

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Last Updated 04/10/2009