PSA screening tests, which are widely used to detect early-stage prostate cancer, have come under fire in recent years for leading to unnecessary treatments and resulting complications, such as incontinence, sexual dysfunction and death.
In May 2012, the U.S. Preventive Services Task Force recommended against PSA-based screening for men of any age. That same month, the American Academy of Family Physicians advised against PSA tests for asymptomatic men. Both groups cited the test's limited benefits and high related rates of unnecessary surgeries and other patient harms.
According to the USPSTF, PSA-based screening and early treatment of prostate cancer results in zero to 1 avoided deaths per 1,000 men screened. “No studies show any benefit in overall death rates,” the panel said.
The USPSTF recommendation was met with protests from the American Urological Association, a specialty group that called the task force's conclusions “inappropriate and irresponsible.” The AUA's current stance on PSA tests acknowledges the risks of overtreatment but stresses the need for an individualized approach with patient education.
Some men will still choose to undergo PSA screening even after receiving detailed information about related benefits and risks, the ACP said in its newly issued guidelines.
“In these circumstances, shared decision-making is important in making choices about prostate cancer screening,” the group said.
