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From the Summer/Fall 2017 Quest

For primary care physicians, discussing the results of PSA tests while practicing shared decision-making can be time consuming and present logistical challenges in clinical practice. A study suggested a different approach to early detection with the PSA test: screen all men with a 10-year or more life expectancy, but only discuss the results with patients if they have a PSA of greater than 1.5.

The reasoning behind this cutoff is that most men with a PSA less than 1.5 have a low risk of developing clinically significant cancer within 5 years. For men with a PSA greater than 1.5, or if the primary care physician finds an abnormality on DRE, the doctor and patient should have an informed discussion to evaluate possible causes. The patient could be referred to a specialist for further testing and to more specifically evaluate his individual risk for prostate cancer.

Urology. 2016 Oct;96:116-120. doi: 10.1016/j.urology.2016.07.001. Epub 2016 Jul 19.

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