COMMENTARY

Prostate Cancer on the Rise; Time to Revisit Guidelines?

Arefa Cassoobhoy, MD, MPH

Disclosures

April 30, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

In 2012, the US Preventive Services Task Force recommended against routine prostate cancer screening of asymptomatic men to detect early disease. Since then, invasive prostate cancer rates have been rising. Is this increase related to the 2012 USPSTF recommendations?

To find out, a recent study[1] looked at outcomes in more than 19,000 men with prostate cancer before and after the recommendations. Although the incidence of low-grade disease and surgical volume both dropped, they saw an increase in more aggressive prostate cancer, higher prostate-specific antigen (PSA) levels, and older age at diagnosis.

Similarly, in another study[2] involving more than 1 million men who had undergone radical prostatectomy, rates of high-stage disease increased after 2012.

PSA screening recommendations are controversial, and the new data encourage us to revisit our screening approach in higher-risk patients.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

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