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From Summer/Fall 2013 Quest

It can be difficult to find the best path when the view is hazy. ©photo by Robert Schini
Prostate Cancer Roundtable Describes Guidance as “Confusing”

In May, the American Urological Association (AUA) issued new guidelines for the early detection of prostate cancer. In response, the Prostate Cancer Roundtable released an online statement that said their members were “increasingly concerned by the utterly confusing guidance” regarding prostate cancer screening. The new AUA guidelines differ from guidelines issued by five other medical organizations.

The Roundtable members suggested that two factors led to the contradictory guidance in the medical community. First, prostate cancer screening has not been adequately studied in men younger than 55 or older than 70 years old or in high-risk populations. They also proposed that the medical community has failed to cooperate and develop guidance “in the interests of patients and families as opposed to the interests of the professional healthcare community.”

The statement expressed concerns with two specific PSA screening guidelines. In response to the recommendation against screening men in their 40s, Merel Nissenberg of the National Alliance of State Prostate Cancer Coalitions said, “Such baseline testing is a way to define individual risk and to help men to understand this.”

Also, the guidelines have not considered the appropriateness of screening men who have the highest risk for prostate cancer because of their family history or ethnicity. Thomas Farrington of the Prostate Health Education Network said, “Multiple studies have shown that black males are at greater risk for prostate cancer-specific mortality than white males of comparable age and health. The lack of explicit guidance about the need for risk testing in this group is potentially a disaster.”

For the present time, the Roundtable asserted that men should advocate for themselves. The statement said, “...we further believe that every man should be encouraged to have a serious discussion with his primary care physician about whether some forms of testing for risk of prostate cancer may be appropriate for him as an individual.”

The Prostate Cancer Roundtable, representing America’s prostate cancer community, is a group of independent, patient-centric, not-for-profit organizations that cooperate to foster the development of policies supporting high quality prostate cancer research, the prevention and early detection of clinically significant prostate cancer, the appropriate care and effective treatment of men with prostate cancer, and the appropriate education of all men at risk for this disease. Visit the group’s website at www.prostatecancerroundtable.net.

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