PURPOSE:An American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) offers timely clinical direction to the ASCO membership after publication or presentation of potentially practice-changing data from major studies.
This PCO addresses the role of prostate-specific antigen (PSA) testing in the screening of men for prostate cancer.
CLINICAL CONTEXT:Prostate cancer is the second leading cause of cancer deaths among men in the United States. The rationale for screening men for prostate cancer is the potential to reduce the risk of death through early detection.
RECENT DATA:Evidence from a 2011 Agency for Healthcare Research and Quality systematic review primarily informs this PCO on the benefits and harms of PSA-based screening. An update search was conducted to March 16, 2012, for additional evidence related to the topic.
RESULTS: In one randomized trial, PSA testing in men who would not otherwise have been screened resulted in reduced death rates from prostate cancer, but it is uncertain whether the size of the effect was worth the harms associated with screening and subsequent unnecessary treatment. Although there are limitations to the existing data, there is evidence to suggest that men with longer life expectancy may benefit from PSA testing. Adverse events associated with prostate biopsy are low for the majority of men; however, several population-based studies have shown increasing rates of infectious complications after prostate biopsy, which is a concern.
Written by:
Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, Parnes H, Loblaw DA, Roth B, Williams J, Nam RK. Are you the author?
Memorial Sloan-Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Ian Thompson, University of Texas Health Science Center at San Antonio, San Antonio, TX; Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA; National Cancer Institute, Rockville, MD; Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Washington University in St Louis, St Louis, MO; Pennsylvania Prostate Cancer Coalition, Camp Hill, PA.
Reference: J Clin Oncol. 2012 Jul 16. Epub ahead of print.
doi: 10.1200/JCO.2012.43.3441
PubMed Abstract
PMID: 22802323
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