wnol.info May 24 2018

Panel: We changed our minds, men should consider regular prostate test

May 24 2018, 01:52 | Rex Rios

Panel: We changed our minds, men should consider regular prostate test

7 2017 Dr. Kirsten Bibbins Domingo poses in her office in San Francisco. Draft recommendations from the US Preventive Services Task Force ditch the old advice against PSA screening and say

"I think they'll be more inclined to have a rational conversation with their patients that are 55 to 69 about the risks and benefits of prostate cancer screening that's PSA based", Dr. Sehgal said.

The health panel reports that new research shows men tested between the ages of 55 to 69 may reduce their chances of actually dying from the disease.

"The draft recommendations released today are thoughtful and reasonable and are in direct alignment with the AUA's clinical practice guidelines and guidelines from most other major physician groups", AUA president Richard K. Babayan, MD, of Boston University, said in a statement.

The panel says its new advice stems from long-term research indicating that for every 1,000 men offered PSA screening, one to two will avoid death from prostate cancer and three will avoid prostate cancer spreading to other organs. The new recommendation is that men discuss the screening with their doctors, changed from the 2012 recommendation against widespread screening. Since then, PSA screening rates have declined by as much as 10 percent, and now fewer than one-third of USA men get the tests.

The task force updates their guidelines every five years.

However, the association doesn't agree men 70 and older should be advised against PSA screening, suggesting these patients could benefit from the test. But none of that has to happen just because an initial PSA test turned up positive. But, in the end, the most important thing for a given man is that he is aware that the science is telling us about benefits and harms, and that he uses that together to make the right decision for himself.

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 21,000 members throughout the world.

Men's Health Network (MHN) is an global non-profit organization whose mission is to reach men, boys, and their families where they live, work, play, and pray with health awareness messages and tools, screening programs, educational materials, advocacy opportunities, and patient navigation.

"We have to work based on solid evidence that is in the medical literature and make a decision based on the balance of benefits and harms", Krist said. That's good news, because in the US, more men are opting for active surveillance.

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Almost three million Americans live with prostate cancer, and many patients undergo surgery or radiation after diagnosis.

The test measures the amount of a protein called prostate-specific antigen (PSA) in the bloodstream.

Prostate cancer is one of the most common types, with about 180,000 cases past year making up nearly 11 percent of the total cancers diagnosed in the United States.

Why is the task force now recommending a change? 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. "The potential side effects of biopsy include pain, bleeding, and infection". The results led to unneeded biopsies, radiation, or surgeries that had life-altering side effects.

The draft recommendation and evidence reviews are posted for public comment for consideration in the final recommendation and evidence review.

The Task Force is an independent, government-supported volunteer group of experts from the nation in the field of prevention and evidence-based medicine. "This isn't a one-size-fits-all" recommendation, said the panel's chair Dr. Kirsten Bibbins-Domingo, a San Francisco internist.

PSA screening, then, is like a dentist applying a sealant to one of your 32 teeth, and that sealant reduces the risk of losing the treated tooth by 20 percent.

Of the 100 with prostate cancer, 80 would typically choose surgery or radiation-either right away or after a period of "active surveillance" or mild treatment options.

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