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From Winter 2013 Quest

We need a forward-looking approach to early detection. ©photo by Dan Oldfield

Recent prostate cancer screening recommendations from the US Preventive Services Task Force (USPSTF) and the American Urological Association (AUA) suggested that PSA testing for prostate cancer should be restricted in certain age groups or stopped altogether, resulting in confusion regarding the role of PSA testing in the early detection of prostate cancer. Consequently, many primary care physicians and internists are no longer ordering routine PSA tests in their patients.

New International Guidelines

The latest screening recommendations released by experts at the Prostate Cancer World Congress and the European Association of Urology (EAU) offered a different perspective. They emphasized that early detection reduces the number of men dying from prostate cancer and developing metastatic disease, and PSA testing is a key element of screening.

Melbourne Consensus Statement

Experts at the Prostate Cancer World Congress in Melbourne, Australia, created a consensus statement on PSA testing to address the conflicting recommendations of various urological groups. The statement highlighted the importance of shared decision-making and the significant improvement in prostate cancer survival rates since the introduction of PSA testing 20 years ago. The authors wrote that an important goal for early detection is to maintain these survival rate gains while minimizing the harms associated with overdiagnosis and overtreatment.

New EAU Guidelines

The updated EAU guidelines emphasized early detection of prostate cancer through an individualized, riskadapted approach rather than widespread mass screening. Baseline PSA testing is an integral component of the guidelines, as is identifying relevant risk factors that can be used to classify patients into risk groups.

“Abandonment of PSA testing as recommended by the USPSTF, would lead to a large increase in men presenting with advanced prostate cancer and a reversal of the gains made in prostate cancer mortality over the past three decades.”

–Melbourne Consensus Statement

Summaries:

Melbourne Consensus Statement

The Melbourne Consensus Statement was published online by BJU International. Dr. Catalona is a signatory on the statement.

EAU Guidelines

The guidelines were published by European Urology in June.

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