US Panel Changes Recommendation on Prostate Cancer Screening

"While it makes theoretical sense that screening may be beneficial for them, there is not enough evidence to suggest that detecting their cancer early will, in the end, make a difference", Trinh said. This trial showed no benefit from screening but - thanks to data sharing - we know the trial wasn't flawless. Other groups say start earlier, depending on family history of prostate cancer and other factors. Figuring out whether to get a PSA test is a complex decision, based upon a patient's risk and other health problems, plus how he feels about the comparative risks of cancer and treatment.

The Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications.

About 70 percent of men with elevated PSA do not have prostate cancer when they are biopsied, according to research.

However, in that same group, 235 men will be recommended for a biopsy, which can cause infection, bleeding and pain.

In the USA study, researchers compared outcomes for men who were screened and decided not to immediately treat their cancer, a practice called active surveillance.

The task force's 2012 advice against screening said there was little evidence that PSA screening was reducing deaths.

Additionally, prostate cancer in many patients may not result in risky complications. "This recommendation applies to African American men, but we remain particularly concerned about the striking absence of evidence to guide these high-risk men specifically as they make decisions about screening".

The USPSTF graded the draft recommendation "C", which means it considers the net benefit of PSA testing small.

And if someone has a slow-growing prostate cancer that doesn't necessarily need treatment, the emotional distress of a cancer diagnosis shouldn't be underestimated, Turini said.

Prostate cancer is one of the most common types among men in the U.S.; almost 13 percent will be diagnosed with it over the course of their lifetimes, according to the National Cancer Institute.

However, other medical groups such as the American Cancer Society have been more nuanced, continuing to recommend regular PSA testing while urging patients and their physicians to discuss the benefits and risks. Instead, they should discuss the uncertainties about the test and order it only if their patients still want it, the panel said. According to the New England Journal analysis, studies imply that 1 prostate cancer death is averted per 1,000 men screened several times each, and followed for 10 to 15 years. For example, tests to check the urine, or how fast the PSA level is rising, or the ratio of the blood level to prostate size. While some men may have symptoms, such as trouble urinating or back pain, for most the disease is silent.

African-American men and men with a family history of prostate cancer are more at risk of developing the disease.

But not everyone with prostate cancer benefits from treatment.

"Many men will have a high PSA at some point in their lives, and most of those will not be prostate cancer but that will be something that the patient and doctor will be anxious about" and will evaluate, Krist told ABC News. The Task Force has developed answers to frequently asked questions, a fact sheet, and infographic to help clarify the draft recommendations.

"Prostate screening has been a contentious issue ever since the prostate specific antigen test became available more than three decades ago".

Men whose greatest concern is reducing their chances of dying from cancer are sometimes willing to face the consequences and choose testing. Because of this reason, many false-positive results could alarm patients unnecessarily, said Dr. Otis Brawley, chief medical officer of the American Cancer Society. And it's rally important that we get the right input and have the discussion about our draft recommendation.

Q: How common is prostate cancer? "The right decision isn't screening all men, it's making all men aware of the benefits and harms, and then allowing each man to make the best decision for himself", Bibbins-Domingo explained.