USPSTF recommends against screening for age 70+
The U.S. Preventive Services Task Force (USPSTF) concludes that the decision to undergo periodic prostate-specific antigen (PSA) screening for prostate cancer should be an individual one for men aged 55 to 69 years. These findings form the basis of a final recommendation statement, published in the May 8 issue of the Journal of the American Medical Association.
Joshua J. Fenton, M.D., M.P.H., from the University of California in Davis, and colleagues conducted a systematic review of the evidence on PSA-based prostate cancer screening and treatments to inform the USPSTF.
Data from 63 studies in 104 publications with 1,904,950 participants were included. Adequate evidence from randomized trials indicated that screening in men aged 55 to 69 years may prevent about 1.3 deaths from prostate cancer over about 13 years per 1,000 men screened. Frequent false-positive results and psychological harms were included as harms of screening, while harms of treatment included erectile dysfunction, urinary incontinence, and bowel symptoms. Based on these findings, the USPSTF concludes that for men aged 55 to 69 years, the decision to undergo PSA-based screening should be an individual one that includes discussion of the potential benefits and harms (C recommendation). For men aged 70 years and older, the USPSTF recommends against PSA-based screening (D recommendation).
“Prostate cancer is one of the most common cancers to affect men and the decision whether to be screened is complex,” USPSTF vice chair Alex H. Krist, M.D., M.P.H., said in a statement. “Men should discuss the benefits and harms of screening with their doctor, so they can make the best choice for themselves based on their values and individual circumstances.”