(Dedham, MA) – Earlier this month, the U.S. Preventive Services Task Force (USPSTF) released its prostate cancer screening draft recommendations for public comment. These latest recommendations show a shift in thinking. Back in 2012, the task force was opposed to routine screening for prostate cancer, a recommendation that resulted in much controversy among urologists as well as The American Urological Association (AUA).
Now, the task force writes: “The decision about whether to be screened for prostate cancer should be an individual one. The USPSTF recommends that clinicians inform men ages 55 to 69 years about the potential benefits and harms of prostate-specific antigen (PSA)–based screening for prostate cancer.”
The 2012 recommendations resulted in a D rating. In its 2017 recommendations, the task force upgraded the rating to C.
Since 2012, studies suggest an increased mortality rate associated with prostate cancer combined with an increase in the numbers and percentage of patients diagnosed with advanced or metastatic prostate cancer. When somebody has a diagnosis of localized prostate cancer, they have a mortality rate that’s somewhere around ten or fifteen percent. When they have metastatic prostate cancer, they have a five-year mortality rate of over fifty percent.
Bottom line: early detection is critical.
Unfortunately, the 2012 recommendations, which opposed regular screening, ultimately put more men’s lives at risk. The newest recommendations should help alleviate that.
Dr. Michael J. Curran, CEO of Greater Boston Urology, says the upgrade is welcome news. “We think this is a step in the right direction because it’s going to get the primary care doctors and the patients back to understanding that getting a PSA check on a regular basis is a good idea.”
Dr. Curran notes that while PSA testing is a very important first step in prostate cancer screening, it is not the indication on whether a patient should have a biopsy. In addition to PSA, urologists can conduct other tests (such as the Prostate Health Index) to further stratify a patient’s risk of prostate cancer.
Dr. Curran says, “At GBU, our recommendation is the primary care doctor should be seeing patients getting regular PSAs. If the PSA is normal and not rising, they don’t necessarily need it every year, with the exception of high-risk groups, who should be screened every year.”
The high-risk groups include African American men, men who have a strong family history of prostate cancer, and men who have a strong family history of breast cancer (or even a personal history of breast cancer, because two percent of all breast cancer patients are men).
If the men are in one of the high-risk groups mentioned above, they should start screening at age 40 and do it every year. Otherwise, all men aged 40 should have a baseline PSA; if it’s normal, the next check would be at age 50.
If the primary care physician is monitoring the PSA and sees the trend of the PSA rising (i.e. they’re seeing the PSA get to a level of 1.5 or 2.0), Greater Boston Urology recommends seeing a urologist.
About Greater Boston Urology
Founded in 2010, Greater Boston Urology is an integrated urology practice. This medical model allows the practice to pool resources, which leads to more—and better—options for patients, such as 3D MRI/ultrasound fusion biopsy, high-intensity focused ultrasound (HIFU), and molecular marker studies, to name just a few. GBU has assembled a team of excellent physicians who serve multiple locations in Greater Boston, the South Shore, and the Cape & Islands. Visit www.GreaterBostonUrology.com to learn more.