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Health: Task force revises prostate cancer screening recommendations



— The U.S. Preventive Services Task Force has upgraded its recommendations about when men should consider a prostate cancer screening. Men under the age of 70 - who have not been previously diagnosed with prostate cancer and are not exhibiting symptoms - are advised to weigh the risks versus benefits when making their decision.

In 2012, the task force recommended against prostate-specific antigen (PSA) blood test for men over the age of 55 who had no previous prostate cancer history and were not exhibiting symptoms. This was upgraded from a D recommendation to a C recommendation, with the task force stating men should visit with their provider and make an informed decision.

The recommendations were released April 11, 2017. The task force remains steadfast in not recommending screening for men older than 70, stating the risks outweigh the benefits.

The task force believes the PSA test reveals an elevated PSA, which may or may not be caused by prostate cancer. While the task force review renewed confidence in screenings reducing the chance of death from prostate cancer, it did note more men are likely to experience risks from screening. Those included false-positive results, repeated blood tests, biopsies, sexual impotence and urinary incontinence.

“Prostate cancer is one of the most common cancers to affect men, and the decision about whether to begin screening using PSA-based testing is complex,” said Alex H. Krist, MD and task force member. “In the end, men who are considering screening deserve to be aware of what the science says so they can make the best choice for themselves, together with their doctor.”

The research reviewed by the task force revealed that for every 1,000 men between age 55 and 69 tested, only one to two will avoid dying of prostate cancer over the next 10 to 15 years. The National Cancer Institute (NCI) states prostate cancer grows very slowly and most men are diagnosed after age 65.

They also state most men diagnosed will not die from the disease. Between 2006 and 2012, 98.9 percent of all prostate cancer patients were surviving five years after the diagnosis.

In the United States, prostate cancer is the most common cancer in men, just after skin cancer based on NCI information. It occurs more often in African-American men. The latest data (2016) shows nearly 181,000 new diagnoses occurred. Just more than 26,000 deaths were related to prostate cancer, accounting for only 4.4 percent of all cancer deaths.

The task force recommends that men with a family history of prostate cancer (a father, brother or son) review the risks and benefits with their healthcare provider. However, they do not recommend the screening in men older than 70 even in the high-risk category.

The task force will accept public comment on its recommendations through May 8. Comments may be submitted online at www.screeningforprostatecancer.org.



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