What are the USPSTF guidelines on prostate cancer screening?

Updated: Jan 15, 2019
  • Author: Lanna Cheuck, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

In 2018, the US Preventive Services Task Force (USPSTF) revised its controversial 2012 recommendation against prostate cancer screening. Currently, the USPSTF advises that in men aged 55 to 69 years, the decision of whether or not to undergo screening should be individualized. This is a grade C recommendation, meaning that there is at least moderate certainty that the net benefit is small. For men aged 70 years and older, the USPSTF recommends against PSA-based screening for prostate cancer. [4]

The USPSTF concluded that currently available data are insufficient to support a separate, specific recommendation on PSA-based screening for prostate cancer in African-American men or in men with a family history of prostate cancer. While acknowledging the higher risk of prostate cancer in those groups, the USPSTF also notes the significantly higher risk of major infections after prostate biopsy in black men than white men, and the potential for harm in men with relatives whose prostate cancer was overdiagnosed. The USPSTF suggests that men with a positive family history who are most likely to benefit from screening are those with a first-degree relative who had advanced prostate cancer at diagnosis, who developed metastatic prostate cancer, or who died of prostate cancer. [4]

In 2015, the European Society for Medical Oncology (ESMO) recommended against population-based PSA screening for prostate cancer, on the grounds that it reduces prostate cancer mortality at the expense of overdiagnosis and overtreatment. The ESMO also recommended against testing for prostate cancer in asymptomatic men over the age of 70 years. [5]


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