Top doctors are calling attention to new guidance on screening for prostate cancer—the second-leading cause of cancer deaths for American men.
The new guidelines—which are laid out in documents being made available to urologists, general MDs and the public this coming week—are significant because they endorse the use of a specific test to screen for prostate cancer—with certain caveats. The guidance, however, rejects a blanket recommendation that calls for all men over the age of 40 to receive such screenings.
"What we're saying in our guideline is that screening as a routine is not recommended in all men," according to new guidelines from the American Urological Association. A panel for the group, also known as AUA, penned the new language.
Because prostate cancer is a slow-moving disease unlike other cancers, patients and doctors must weigh the risks of testing against quality-of-life issues. And screening comes with risks including potentially unnecessary biopsies and side effects such as erectile dysfunction.
"The real issues for the panel was how to increase the benefits [of testing] and reduce the harm at the same time," according to AUA's new guidelines.
Testing Guidelines: Plenty of Opinions
AUA's new guidance recommends that all men between the ages of 55 to 69 should discuss the value and frequency of receiving Prostate-Specific Antigen, or PSA, screening because the association believes that age group is more likely to benefit from such screenings.
The new guidelines also call out and recommend that all African-American men, those males with a history of prostate cancer among their fathers, sons and brothers, and men with urinary symptoms talk to their doctors about prostate-cancer screening.
Investor Warren Buffett discovered he had prostate cancer after years of monitoring his PSA levels. A higher reading prompted a biopsy that led to the diagnosis.
Not unlike mammogram testing for breast cancer among women, there are plenty of opinions among patients and medical experts about screening for prostate cancer.
The association's guidelines on the efficacy of PSA tests contrasts with the U.S. Preventative Task Force, which last year recommended against the test being used for screening. The task force—a volunteer panel of national experts in prevention and evidence-based medicine—said the test carries a very small potential benefit and potential risks.
On the other hand, AUA's guidelines contrast with some medical practitioners, who believe all men should get a PSA test.
"We did not believe that the PSA should be disregarded. It's a useful test, it saves lives, it prevents deaths from prostate cancer," said Dr. H. Ballentine Carter, the director of adult urology at the Johns Hopkins University School of Medicine in Baltimore, and chairman of the association panel that drew up the new prostate cancer detection guideline.
(Infographic: Is Prostate Cancer Screening Right For You?)