The American Urological Association (AUA) issued new guidelines on prostate cancer screening with supports the routine use of the prostate-specific antigen (PSA) test in healthy men, but only for a specified age group, the group said in a statement released Friday.
The new guideline recommends that routine screening is no longer required for men 40 to 54 years old at average risk of getting prostate cancer. Screening is also not recommended for men 70 and older.
This is a major difference from the guidelines issued last year by the US Preventative Services Task Force (USPSTF), which recommended against any routine use of the PSA test, concluding that any benefit is outweighed by harm.
"It's time to reflect on how we screen men for prostate cancer and take a more selective approach in order to maximize benefit and minimize harms," Dr. H. Ballentine Carter, a professor of urology and oncology at Johns Hopkins University and chairman of the committee that drafted the guidelines.
"The public is very enthusiastic about screening, partly because of our messaging," Carter says. "The idea that screening delivers benefits may have been overexaggerated."
But Carter notes that "if a physician and patient sit down and the patient really, really understands the risks and benefits, then it's been absolutely proven that a substantial minority will not choose to be screened."
The urology association's previous recommendation, issued in 2009, was that blood testing for PSA, which stands for prostate-specific antigen, should be offered to men starting at age 40.
However, the statement noted that men with prostate pain or other problems should still talk to their doctors about their symptoms. Younger men at high risk of prostate cancer should also ask their doctor's advice. Men at higher risk include African Americans and those with a very strong family history of prostate cancer, defined as cancer that develops before age 50, in multiple first-degree relatives, such as fathers or brothers, Carter says.
