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From Winter 2013 Quest

by William J. Catalona, MD


By recommending that PSA testing should be abandoned completely or restricted, the USPSTF and the AUA guidelines are a step in the wrong direction for patient-centered care. If widely implemented, these guidelines would deprive many men of the opportunity to pursue shared decisionmaking about possibly life-saving PSA testing. A more forward-looking approach is needed. As stated by Dr. Harold Sox, “Weighing the pros and cons...is an individual process, and different well-informed men will make different decisions...guidelines should avoid recommending for or against PSA screening, rather we should recommend a shared decision process that includes assessing patients feelings about what they could go through after screening.”1

In the absence of shared decisionmaking, patients are more than twice as likely not to get tested. The future will bear out that PSA screening greatly reduces suffering and death from prostate cancer. The benefits far outweigh the harms.


1 Sox HC. N Engl J Med. 2012; 367:669-71

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