Tags: Cancer | prostate | cancer | psa | screening | guideline

PSA Guidelines Drive Drop in Cancer Diagnoses

By    |   Thursday, 18 June 2015 10:49 AM

New diagnoses of prostate cancer have dropped by more than quarter since federal health officials recommended against routine PSA screening in 2011, a new study finds.

The research, led by Vanderbilt University Medical Center investigators, raises new questions about whether the recommendation from the United States Preventive Services Task Force is leaving some men vulnerable to cancer because they are not being screened.

Lead research Daniel Barocas, M.D., an assistant professor of urological surgery and medicine, suggested the findings – published online in The Journal of Urology – should prompt a review of the guidelines.

“These findings suggest that reduced screening may result in missed opportunities to spare these men from progressive disease and cancer death,' said Dr. Barocas.

In October 2011, the USPSTF issued a draft guideline discouraging the use of prostate-specific antigen (PSA) screenings after concluding the test is not foolproof and that harms outweigh potential benefits. Harmful side effects of treatment may include incontinence, erectile dysfunction, and radiation cystitis.

By many health advocates criticized the recommendation, noting PSA tests – while imperfect -- can help identify men at risk for developing aggressive prostate cancer, which is the second leading cause of cancer death among men in the U.S., with nearly 30,000 deaths annually.

For the new study, the investigators tracked new cancers diagnosed between January 2010 and December 2012 in the National Cancer Database. They studied the trend of prostate cancers diagnosed each month before and after the draft guideline, compared with new colon cancer cases.

The results showed that 12 months after the draft USPSTF guidelines were published diagnoses of new low-risk cancers had fallen by 37.9 percent while colon cancer cases remained stable.
New prostate cancer diagnoses also dropped by up to 29.3 percent among men over age 70 and 26 percent among men considered infirm.

The investigators suggested that withholding screening may result in failure to detect higher-risk cancers early, when they can be most effectively treated.

“The results raise concern that if this trend continues more men may be diagnosed at a point when their disease is advanced. Younger, healthier men with intermediate or high-risk disease would normally be candidates for aggressive local therapy and they may not be receiving a timely diagnosis under this policy,” said Barocas.

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Prostate cancer have dropped by more than quarter since federal health officials recommended against routine PSA screening in 2011, a new study finds.
prostate, cancer, psa, screening, guideline
Thursday, 18 June 2015 10:49 AM
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