Claim: U.S. Panel Questions Prostate Screening
Verdict: SUPPORTS

Retrieved passages:
title: United States Preventive Services Task Force
text: In the current recommendation published in 2012, the Task Force recommended against prostate-specific antigen (PSA)-based screening for prostate cancer. The Task Force gave PCa screening a D recommendation. A final statement published in 2018 recommends basing the decision to screen on shared decision making in those 55 to 69 years old. It continues to recommend against screening in those 70 and older. From 1984 to 1989, the task force's stated purpose was to "develop recommendations for primary care clinicians on the appropriate content of periodic health examinations." United States Preventive Services Task Force The United States Preventive Services Task Force

title: Prostate cancer screening
text: indicator of prostate cancer, but may also detect prostatitis or benign prostatic hyperplasia. A 2018 United States Preventive Services Task Force (USPSTF) draft reversed the prior opposition to PSA screening. The draft recommendations suggest shared decision-making regarding screening in healthy males 55 to 69 years of age. The final recommendation for that age group states screening should only be done in those who wish it. In those 70 and over, screening remains not recommended. Screening with PSA has been associated with a number of harms including over-diagnosis, increased prostate biopsy with associated harms, increased anxiety, and unneeded treatment. On the

title: Cancer screening
text: inadequate for intercourse). The U.S. Preventative Services Task Force (USPSTF) recommends against prostate-specific antigen (PSA) based screening for prostate cancer finding, "there is a very small potential benefit and significant potential harms" and concluding, "while everyone wants to help prevent deaths from prostate cancer, current methods of PSA screening and treatment of screen-detected cancer are not the answer." Most North American medical groups recommend individualized decisions about screening, taking into consideration the risks, benefits, and the patients' personal preferences. Screening studies for lung cancer have only been done in high risk populations, such as smokers and workers with occupational exposure

title: Prostate cancer screening
text: your risk factors and weighing your personal preferences." A study in Europe resulted in only a small decline in death rates and concluded that 48 men would need to be treated to save one life. But of the 47 men who were treated, most would be unable to ever again function sexually and would require more frequent trips to the bathroom. Aggressive marketing of screening tests by drug companies has also generated controversy as has the advocacy of testing by the American Urological Association. One commentator has observed: “[I]t is prudent only to use a single PSA determination as a

title: Active surveillance of prostate cancer
text: of men undergo curative intervention after receiving a prostate cancer diagnosis. A range of estimates of over diagnosis between 23% and 42% have been reported based on U.S. incidence. Depending upon the age at diagnosis, and the disease characteristics, the likelihood that a screen detected cancer has been over diagnosed can vary from below 5% to more than 75%. An unintended consequence of new technology is its use among those least likely to benefit. A disturbing trend has been noted in men with newly diagnosed prostate cancer treated with robotic surgery and newer forms of radiotherapy (IMRT). A 2013 study

title: Prostate cancer screening
text: 1410 men would need to be screened and 48 additional cases of prostate cancer would need to be treated to prevent just one death from prostate cancer within 9 years. A study published in the European Journal of Cancer (October 2009) documented that prostate cancer screening reduced prostate cancer mortality by 37 percent. By utilizing a control group of men from Northern Ireland, where PSA screening is infrequent, the research showed this substantial reduction in prostate cancer deaths when compared to men who were PSA tested as part of the ERSPC study. A study published in the New England Journal

title: Prostate cancer
text: a decision should be made by the person in question based on the potential risks and benefits. In general, they concluded, "it is uncertain whether the benefits associated with PSA testing for prostate cancer screening are worth the harms associated with screening and subsequent unnecessary treatment." American Urological Association (AUA 2013) guidelines call for weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a ten-year period against the known harms associated with diagnostic tests and treatment. The AUA recommends offering screening to those 55 to 69 be based on shared decision making,

title: Prostate cancer screening
text: of Medicine in 2009 found that over a 7 to 10-year period, "screening did not reduce the death rate in men 55 and over." Former screening proponents, including some from Stanford University, have come out against routine testing. In February 2010, the American Cancer Society urged "more caution in using the test." And the American College of Preventive Medicine concluded that "there was insufficient evidence to recommend routine screening." A further study, the NHS Comparison Arm for ProtecT (CAP), as part of the Prostate testing for cancer and Treatment (ProtecT) study, randomized GP practices with 460,000 men aged 50–69 at

title: Prostate cancer
text: about the positives and negatives. The United States Preventive Services Task Force (USPSTF) suggests the decision whether or not to have PSA screening be based on decision making between the patient and physician for men 55 to 69 years of age. USPSTF recommends against PSA screening for males who are age 70 or older. The Centers for Disease Control and Prevention shared USPSTF's prior conclusion. The American Society of Clinical Oncology and the American College of Physicians discourage screening for those who are expected to live less than ten to fifteen years, while in those with a greater life expectancy

title: Overscreening
text: risks outweigh the potential benefits. Guidelines from the American Urological Association, and the American Cancer Society recommend that men be informed of the risks and benefits of screening. The American Society of Clinical Oncology recommends screening be discouraged in those who are expected to live less than ten years, while in those with a life expectancy of greater than ten years a decision should be made by the person in question based on the potential risks and benefits. In general, they conclude that based on recent research, "it is uncertain whether the benefits associated with PSA testing for prostate cancer

title: Prostate cancer
text: and that if screening is performed it should occur no more often than every two years. In the United Kingdom as of 2015 there is no program to screen for prostate cancer. The first decision to be made in managing prostate cancer is whether treatment is needed. Prostate cancer, especially low-grade forms found in elderly men, often grows so slowly that no treatment is required. Treatment may also be inappropriate if a person has other serious health problems or is not expected to live long enough for symptoms to appear. Alternative approaches that delay active treatment and instead involve surveillance

title: Prostate-specific antigen
text: in the presence of prostate cancer or other prostate disorders. PSA is not a unique indicator of prostate cancer, but may also detect prostatitis or benign prostatic hyperplasia. Clinical practice guidelines for prostate cancer screening vary and are controversial due to uncertainty as to whether the benefits of screening ultimately outweigh the risks of overdiagnosis and over treatment. In the United States, the U.S. Food and Drug Administration (FDA) has approved the PSA test for annual screening of prostate cancer in men of age 50 and older. The patient needs to be informed of the risks and benefits of PSA

title: Active surveillance of prostate cancer
text: death from prostate cancers detected through screening would be 0-2% for men age 55–74 years with Gleason score 6 or less managed without treatment. These low grade prostate cancers make up 60-70% of the cancers found with PSA based screening. Thus, the pool of disease carrying a low risk of cancer related death without treatment over a 10-15 year period is large with PSA based screening. The control arm (untreated) of randomized trials comparing surgery to watchful waiting represents an opportunity for evaluating the natural history of prostate cancer. The Scandinavian Prostate Cancer Group Study-4 (SPGS-4) randomized 695 men (mean

title: Prostate cancer screening
text: centers in 9 cities in Britain from 2001–2005 to usual care or prostate cancer screening with PSA (biopsy if PSA ≥ 3). The "Comparison Arm" has yet to report as of early 2018. Prostate cancer screening Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in those without signs or symptoms. When abnormal prostate tissue or cancer is found early, it may be easier to treat and cure, but it is unclear if early detection reduces mortality rates. Screening precedes a diagnosis and subsequent treatment. The digital rectal examination (DRE) is one screening tool during which

title: Prostate cancer screening
text: with prostate-specific antigen (PSA) or digital rectal exam (DRE) reduces mortality from prostate cancer. A 2013 Cochrane review concluded PSA screening results in "no statistically significant difference in prostate cancer-specific mortality..." The American studies were determined to have a high bias. European studies included in this review were of low bias and one reported "a significant reduction in prostate cancer-specific mortality." PSA screening with DRE was not assessed in this review. DRE was not assessed separately. Guidelines generally recommend that the decisions whether or not to screen be based on shared decision-making. This involves men being informed of the risks

title: Prostate cancer screening
text: detecting "high-risk", potentially lethal prostate cancer, with the understanding that lower-risk disease, if discovered, often does not need treatment and may be amenable to active surveillance. Screening for prostate cancer is controversial because of cost and uncertain long-term benefits to patients. Horan echos that sentiment in his book. Private medical institutes, such as the Mayo Clinic, likewise acknowledge that "organizations vary in their recommendations about who should – and who shouldn't – get a PSA screening test. They conclude: "Ultimately, whether you should have a PSA test is something you'll have to decide after discussing it with your doctor, considering

title: Cancer screening
text: with Cologuard test has been FDA-approved. In England, adults are screened biennially via faecal occult blood testing between the ages of 60 and 74 years. When screening for prostate cancer, the PSA test may detect small cancers that would never become life-threatening, but once detected will lead to treatment. This situation, called overdiagnosis, puts men at risk for complications from unnecessary treatment such as surgery or radiation. Follow up procedures used to diagnose prostate cancer (prostate biopsy) may cause side effects, including bleeding and infection. Prostate cancer treatment may cause incontinence (inability to control urine flow) and erectile dysfunction (erections

title: Prostate cancer screening
text: to other causes. During a digital rectal examination (DRE), a healthcare provider slides a gloved finger into the rectum and presses on the prostate, to check its size and to check whether any lumps are present. If the examination suggests anomalies, a PSA test is performed. If an elevated PSA level is found, a follow-up test is then performed. A 2018 review recommended against primary care screening for prostate cancer with DRE due to the lack of evidence of the effectiveness of the practice. Prostate biopsies are considered the gold standard in detecting prostate cancer. Infection is a possible risk.

title: Prostate cancer screening
text: continue to decline, 238,590 men were diagnosed with prostate cancer in 2013 while 29,720 died as a result. Death rates from prostate cancer have declined at a steady rate since 1992. Cancers of the prostate, lung and bronchus, and colorectum account for about 50% of all newly diagnosed cancers in men. Prostate cancer alone constitutes 28% cases in men. Screening for prostate cancer varies by state and indicates differences in the use of screening for prostate cancer as well as variations between locales. Out all cases of prostate cancer, African american men have an incidence of 62%. African American men

title: Prostate cancer screening
text: and benefits of screening. The American Society of Clinical Oncology recommends screening be discouraged in those who are expected to live less than ten years, while in those with a life expectancy of greater than ten years a decision should be made by the person in question. In general, they conclude that based on recent research, "it is uncertain whether the benefits associated with PSA testing for prostate cancer screening are worth the harms associated with screening and subsequent unnecessary treatment." Prostate biopsies are used to diagnose prostate cancer but are not done on asymptomatic men and therefore are not