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Cancer Specialists Support PSA Testing for Men With Longer Life Expectancies

The benefits of PSA testing include identifying higher-risk prostate cancer earlier, when treatment may be more effective, while the risks include over-diagnosis, unnecessary biopsy and treatment, and treatment side effects.

ASCO’s opinion was published on July 16 in the online edition of the Journal of Clinical Oncology. The statement includes the following recommendations:

  • In men with a life expectancy of less than or equal to 10 years, it is recommended that general screening for prostate cancer PSA testing be discouraged. For these men, the evidence of harm seems to outweigh potential benefits.
  • In men with a life expectancy of greater than 10 years, it is recommended that physicians discuss with their patients whether PSA testing for prostate cancer screening is appropriate for them. PSA testing may save lives in this group of men, but it is also associated with harm, including complications from unnecessary biopsy, surgery, or radiation treatment for cancers that may be slow-growing and not ultimately life-threatening.
  • It is recommended that information written in lay language be available to clinicians and their patients to facilitate discussions of the benefits and risks associated with PSA testing before the routine ordering of a PSA test.

This guidance differs from a statement issued in May 2012 by the U.S. Preventive Services Task Force (USPSTF), which recommends against PSA-based screening for prostate cancer.

ASCO also released a new, detailed decision aid to help men and their physicians understand the risks and benefits of screening, and to decide whether PSA testing is the appropriate choice.

Read the news release on the ASCO Web site.

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