The U.S. Preventive Services Task Force issued a potentially life-saving new guideline for prostate cancer screening on April 11. In a change from the 2012 recommendation against screening using the prostate specific antigen (PSA) blood test, the task force now recommends “individualized decision-making about screening for prostate cancer after discussion with the clinician so that each man has the opportunity to understand the potential benefits and harms of screening.”
“This change is specifically important for African-American men, who have the highest incidence of prostate cancer and are at more than double the risk of dying from the disease then men of other ethnicities,” said Dr. Lannis Hall, co-founder of the Prostate Cancer Coalition and director of Radiation Oncology at Siteman Cancer Center, Barnes-Jewish St. Peters Hospital.
When the task force first reviewed the medical literature around prostate cancer in 2012, its conclusion was that screening resulted in more harm than benefit. Many organizations, including the American Urologic Association and the St. Louis Prostate Cancer Coalition, opposed that position and feared an increase in prostate cancer morbidity and mortality.
“The new guideline is a step in the right direction,” Hall said.
The task force now recommends that clinicians inform men 55 to 69 years of age about the potential benefits and harms of PSA-based screening for prostate cancer. The task force also acknowledges that given the higher rates of aggressive cancer in African-American men, “PSA-based screening may provide greater benefit to African-American men than the general population.”
“The Prostate Cancer Coalition is gratified that this updated guideline supports shared decision-making and acknowledges the importance of further research to understand the disparity in incidence and survival in African-American men,” said Dr. Arnold Bullock, co-founder of the Prostate Cancer Coalition and professor of Urology at Washington University School of Medicine.
The Prostate Cancer Coalition is comprised of St. Louis health care providers, community health advocacy groups, and survivors interested in raising awareness about the importance of prostate cancer in the African-American community and other high-risk men. Their goal is to inform physicians and the community of the disproportionately high risk of developing and dying of prostate cancer in African-American men and to highlight statistics indicating that PSA screening has led to improvement in survival in all men, regardless of ethnicity over the last 25 years.
The coalition supports the American Cancer Society’s position that there should be a discussion about the risks and benefits of screening, beginning at the age of 45 for African-American men and younger if a strong family history. It holds that discussion should also emphasize the significant advancements in the detection and staging of prostate cancer and that PSA is just one of many tests available to help make an educated decision.
The new recommendation is a draft statement, and anyone can submit a comment for review before these guidelines are finalized. Read the draft statement and leave comments at https://screeningforprostatecancer.org/.
For more information on the Prostate Cancer Coalition, free screenings and community events in the St. Louis area, visit Prostatecancercoalition@stl.org.
