U.S. agency notes limits of prostate cancer screening
Published Wednesday, March 3, 2010 7:38PM EST
ATLANTA - New advice from the American Cancer Society puts a sharper focus on the risks of prostate cancer screening, emphasizing that annual testing can lead to unnecessary biopsies and treatments that do more harm than good.
The cancer society has not recommended routine screening for most men since the mid-1990s, and that is not changing. But its new advice goes farther to warn of the limitations of the PSA blood test that millions of American men get now. It also says digital rectal exams should be an option rather than part of a standard screening.
The new advice is the latest pushback from routine screening to hunt for early cancers. Last year, a government task force said most women don't need mammograms in their 40s and a doctors group said most women in their 20s don't need annual Pap tests.
American men have long been urged to have prostate cancer screenings, but over time studies have suggested that most cancers found are so slow-growing that most men could have avoided treatment.
The Atlanta-based cancer society is perhaps the most influential group in giving screening advice. Its new guidance released Wednesday on prostate cancer urges doctors to:
-Discuss the pros and cons of testing with their patients, including giving them written information or videos that discuss the likelihood of false test results and the side effects of treatment.
-Stop giving the rectal exam as a standard prostate cancer screening because it has not clearly shown a benefit, though it can remain an option.
-Use past PSA readings to determine how often followup tests are needed and to guide conversations about treatment.
Prostate cancer is the most common non-skin cancer in American men. An estimated 192,000 new cases and 27,000 deaths from it occurred last year in the United States.
But it is a slow-growing cancer in many cases, and depending on a man's age, he may be more likely to die of something else. Major studies have suggested routine screening doesn't save lives and often leads to worry and unnecessary treatment.