ITEMS IN AFP WITH KEYWORD:
Before primary care physicians consider reintroducing the PSA test, they must have proof that it improves outcomes. The task will be to show in a future randomized study whether any PSA screening algorithm can improve survival or quality of life compared with what is now the standard of care—no routine screening.
Studies show no deaths were prevented and 1 in 5 underwent a prostate biopsy for a false-positive test. Read more.
Jan 15, 2014 Issue
AUA Releases Guideline on Early Detection of Prostate Cancer [Practice Guidelines]
In April 2013, the American Urological Association (AUA) released a guideline on early detection of prostate cancer, namely to reduce prostate cancer mortality.
Although finasteride prevents low-grade prostate tumors, it does not affect overall survival or survival after prostate cancer diagnosis. Although high-grade cancers were more common among men taking finasteride, up to 18 years of follow-up failed to show increased mortality in this group.
Patients undergoing surgery had worse urinary and sexual outcomes, whereas those undergoing external beam radiation therapy (EBRT) had worse bowel symptoms. Watchful waiting (“active surveillance”) was not the subject of this study, but given the problems associated with therapy, active surveillance...
Feb 15, 2013 Issue
Screening for Prostate Cancer: Recommendation Statement [U.S. Preventive Services Task Force]
The U.S. Preventive Services Task Force (USPSTF) recommends against prostate-specific antigen (PSA)-based screening for prostate cancer.
Case Study: A 61-year-old black man presents for a routine checkup. He has hypertension and diabetes mellitus that are well controlled with medication. During the visit, he tells you that a friend advised him to get a prostate-specific antigen (PSA) test to screen for prostate cancer, and he would like to pursue testing.
In the United States, more than 90 percent of prostate cancers are detected by serum prostate-specific antigen testing. Most patients are found to have localized prostate cancer, and most of these patients undergo surgery or radiotherapy. However, many patients have low-risk cancer and can follow an...
Apr 1, 2011 Issue
Screening for Prostate Cancer: Prostate-Specific Antigen Testing Is Not Effective [Cochrane for Clinicians]
Several large randomized controlled trials show that PSA screening does not significantly reduce prostate cancer mortality, even in a U.S. study that included black men and men with a family history of prostate cancer. However, PSA screening does lead to overdiagnosis, overtreatment, and treatment-associated morbidity.
Although there have been substantive advances in the understanding of prostate cancer screening since the previous American Cancer Society (ACS) guideline update in 2001, there are still uncertainties about the overall value of early detection. Evidence that periodic prostate-specific antigen (PSA) ...