The US Preventive Services Task Force's grade "D" recommendation against routine PSA screening this May has generated controversy and left many patients and providers confused about the role of PSA screening as a strategy to reduce suffering and death from prostate cancer.
Dr. Matthew Nielsen, Assistant Professor of Surgery/Urology says, "While the Task Force should be commended for highlighting the potential harms of indiscriminate PSA testing and nonselective treatment of screen-detected disease, this recommendation suggests a certainty of harm outweighing benefits that is not consistent with all available data. Given the 40% reduction in prostate cancer mortality and the massive reduction in the proportion of men diagnosed with metastatic disease since the introduction of PSA screening, as well as the major limitations of some of the data selected for review by the task force, we believe that a strong case can still be made that, in appropriately counseled and selected men, PSA testing and biopsy, and broader application of active surveillance represent current standard approaches to reduce overtreatment and shift the balance towards net benefit. We believe that the data support shared decision making between a patient and his doctor, not categorical abandonment of PSA testing, which would be a major step backwards."
UNC Urology supports the AUA's efforts to address this controversial recommendation, including a toolkit of information resources <http://www.auanet.org/content/health-policy/government-relations-and-advocacy/in-the-news/uspstf-psa-toolkit.cfm> (H.R. 5998), authored with substantial input from the AUA, which would uncouple Task Force recommendations from Medicare coverage and provide a forum for more meaningful input in the recommendations drafting process from important stakeholders, including patients and physicians with expertise in diseases under review.
To read the AUA news release click here.