07 mar 2010-- Men should participate in shared decision-making over whether or not they undergo screening for prostate cancer, according to updated guidelines for prostate cancer screening from the American Cancer Society, published online March 3 in CA: A Cancer Journal for Clinicians. These guideline updates are the first since 2001.
Andrew M.D. Wolf, M.D., of the University of Virginia School of Medicine in Charlottesville, and colleagues write that a series of systemic reviews of evidence were undertaken by the American Cancer Society Prostate Cancer Advisory Committee in 2009 to facilitate the updating process. The evidence showed that men without symptoms of prostate cancer and at least 10 years' life expectancy can and should make an informed decision about the pros and cons of prostate cancer screening. Men at average risk should be given the information they need to fully participate in the decision-making process at the age of 50, while men at higher risk should be educated about prostate cancer screening earlier. Annual screening is recommended for men who choose to be tested and who have a prostate-specific antigen (PSA) level of 2.5 ng/mL or higher. Men with a PSA under that threshold can be safely screened every two years, per the new recommendations, while men with a PSA level of 4.0 ng/mL or higher should consider getting further evaluation. "Two decades into the PSA era of prostate cancer screening, the overall value of early detection in reducing the morbidity and mortality from prostate cancer remains unclear," Wolf, chair of the advisory committee, said in a statement. "While early detection may reduce the likelihood of dying from prostate cancer, that benefit must be weighed against the serious risks associated with subsequent treatment, particularly the risk of treating men for cancers that would not have caused ill effects had they been left undetected."
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