Experts Propose Changes To Prostate Cancer Screening Guidelines

7 2017 Dr. Kirsten Bibbins Domingo poses by a mural in the lobby of her office in San Francisco. Draft recommendations from the US Preventive Services Task Force ditch the old advice against

CHICAGO (AP) — An influential US government health panel is dropping its opposition to routine prostate cancer screening in favor of letting men decide for themselves after talking with their doctor. But there is confusion over conflicting advice about whom should get tested for the disease.

One specialist views the new recommendation as a correction of an error the task force made in 2012.

Here's where some of the confusion started. About 36 percent of men chatted with their doctors only about the benefits of screening.

The task force's initial recommendation generated political heat, and in 2015 Reps. After examining the latest crop of studies published up through October 2016, the task force concluded that the answer would depend on whether a man placed a higher priority on avoiding prostate cancer or on avoiding unnecessary medical procedures that could affect his quality of life. What's the evidence behind your recommendation? The key here is that men should have this discussion.

"But the right decision is not a one-size-fits-all decision".

As an oncologist who cares for cancer patients, I have no desire to trivialize cancer, and I know that prostate cancer is far worse than losing a tooth.

There are new recommendations regarding screening for prostate cancer.

Dr. Dan Merenstein, a family medicine physician at Georgetown University, doesn't think the new evidence warrants a change.

The new USPSTF guideline gives PSA testing a grade of C, which essentially means that there are risks and benefits and a doctor should have a discussion with a patient to help reach a decision regarding whether or not the PSA should be checked.

The PSA test is a simple test that allows for researchers to identify a particular protein. A re-evaluation of the evidence is behind the update. The task force says the increasing use of watchful waiting is helping to spare more men the side effects of over-aggressive treatment.

For men between the ages of 55 and 69, getting screened for prostate cancer is a mixed bag of possible, down-the-road benefits and just-as-possible immediate harms. When it appears in middle-aged men, it frequently develops so slowly that it's rarely the cause of death, so treating it with invasive and toxic therapies like surgery, chemotherapy and radiation often exposes men to more side effects and harms without protecting them from dying from that cancer.

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"I do think you'll see a change with primary care doctors".

Instead of treatment, many men with low-risk prostate cancer can opt for active surveillance, which may reduce the chance of overtreatment.

The European Association of Urology says screening should be offered to well-informed men over 50 or over 45 for blacks and those with a family history.

Editor's note: Otis Brawley is chief medical officer of the American Cancer Society. They are very happy with your new guidelines. "The most important thing is for doctors and patients together to have a conversation", says Bibbins-Domingo, "so that men can make the best decision for themselves".

You can weigh in, too. This is a complex decision.

At the same time, no one denies that screening really does save lives every day. Adults have 32 (or 28 if your wisdom teeth are gone), and most of us want to keep every last one. Right now, the new guidelines are a draft.

Bibbins-Domingo said that more research is needed to figure out whether to screen these men more aggressively than the general population.

WILLIAM BRANGHAM: So, the recommendations are, 55 to 69, strongly consider the test, talk to your doctor about it, men over 70, not necessary. It is rare in men younger than 40.

The U.S. National Cancer Institute provides more information on prostate cancer screening.

In 2012, 63 percent of men underwent PSA tests. Prostate cancer is the most common cancer in American men; the American Cancer Society projects more than 161,000 new cases this year in the USA, with about 26,730 deaths. So do men with a family history. For these men, hunting for prostate cancer risked pain, worry and expense without saving lives or even warding off metastasis. "This is not a recommendation that says men should go get screened".

The risk of potential harm of over-diagnosis has led to confusing recommendations for screening.

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