The federal task force softened its opposition to cover for conventional prostate cancer.
An influential federal task force is relaxing its controversial routine screening of prostate cancer.
Is put forward by the revised formula on Tuesday the U.S. preventive services task force said that men aged 55 to 69 should be alone with their doctor to decide whether and when to prostate specific antigen (PSA) test.
The task force will continue to recommend PSA testing for men aged 70 and over, adding that the potential harm continues to outweigh the benefits of routine screening in that age group.
The proposal has yet to be finalized, waiting for public feedback, and five years after the panel recommended regular use of common blood tests, the proposal has not yet been finalized. The 2012 guidance prompted a significant drop in PSA testing.
Every year, nearly 180,000 American men are diagnosed with prostate cancer, and at least 26,000 people die from the disease, making it one of the most common and deadly cancers in men.
The working group decided to adjust screening recommendations based on new research.
“The new evidence allows us to say, in a word, we think the benefits of the present outweigh the risks,” said Dr. Kirsten bibbs-domingo, a professor of medicine at the university of California, San Francisco. She says the latest research also shows that screening can bring a little net benefit.
“So,” says bibbon-domingo, “we recommend that doctors and patients talk about screening for them.”
While PSA tests can detect prostate cancer at the smallest, most treatable stage, she says, there is a risk.
Hazards include the stress of often causing painful and sometimes dangerous biopsies. Even if the tests detect actual malignancies, many prostate cancers grow so slowly that they will never pose a threat to life. Still, many men receive surgery and radiotherapy, which can make them incontinent or powerless.
“PSA testing is not a good test,” says bibbs-domingo. “It doesn’t help us distinguish which cancers will kill you, and these cancers will not progress over time and will not lead to men’s health problems.”
As a result, when the panel released its guidelines in 2012, the panel concluded that the potential dangers of screening outweigh the benefits.
The task force says the results of the past five years have changed that equation.
Specifically, the European randomized study of prostate cancer screening (ERSPC) found that PSA testing reduced the risk of developing advanced prostate cancer by about 30 percent, and the risk of dying from disease by about 20 percent.
At the same time, a growing number of men are skipping treatment for prostate cancer diagnosis, according to a recent study. Instead, they and their doctors chose to “watch out” or actively monitor a malignant tumor. The working group says the less aggressive treatment can minimize the risk of screening.
Therefore, in the revision of the proposal, special working group to give up the PSA test aged 55 to 69 – year – old male “D” Suggestions, with a “C” suggested instead, the proposal to determine whether every male of the ages to separate screening – consult his doctor.
“Some men might say, ‘you know, I really want to prevent prostate cancer death, this is one of the most important to me, so even though there is little possibility of this happening, I also want to do this,'” said Bibbins – placido Domingo. For every 1, 000 screeners, screening saves about one or two lives.
“There’s a risk of impotence or incontinence, and for some men it’s a reasonable option,” says bibbon-domingo. “I don’t want to risk things that might happen.”
Doctors who have long advocated a positive PSA test have praised the new guidelines.
“I’m very happy that this is a victory for PSA screening for prostate cancer,” said Dr. William catron, a professor of urology at northwestern university’s inberg school of medicine.
“PSA screening saves lives,” he said. “Let the U.S. preventive services task force to prevent PSA screening has created an entire generation of family doctors and physicians, they think that PSA screening for patients is a bad thing, if this continues, we will lose all these benefits in reducing the mortality of prostate cancer. “He said he wanted the group to go further, and suggested that doctors actively encourage PSA screening, which starts at 40 and lasts until the age of 70.
Dr. David Penson, a urologist at vanderbilt-ingram cancer center, agreed with the task force. “I think it’s a great thing for men to make their own decisions,” he said, noting that the new guidelines are in line with those of other medical groups.
Dr. Dan Merenstein, a family physician at Georgetown university, believes the new evidence is not worth changing. He worries that the new guidelines are confusing.
Merenstein said: “what I’m afraid of is not this kind of discussion – it’s a difficult and lengthy discussion – doctors will do what they do with a cholesterol test group,” Merenstein said. “That would do more harm than good.”
At the same time, Dr. Otis Brawley, chief medical officer of the American cancer society, said the guidelines were in the right balance.
“I do think we have a lot of wobbles in medicine,” brawley said. “The pendulum could reach the right place, here we are aware of the dangers of existence, and there is profit, and individuals need to weigh the damage and benefits, and tailored for the decision for them.”