Technology and Scienceupdated 30m ago3 min read
Archive photo · 15 October 2020American Cancer Society Updates Prostate Cancer Screening With Regular PSA Testing
10 Western Mainstream3 Other1 West AsianPhoto: U.S. Air Force photo by Airman 1st Class Jennifer Gonzales / US federal government, Public domain · Cropped for layout
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PSA screening every two years from age 50 to 69 for average-risk men. High-risk individuals begin at 45 with annual PSA testing.
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ACS sets PSA schedule
The American Cancer Society updated its prostate cancer screening guidelines to encourage more men to get tested at set intervals, with the organization now recommending PSA-based screening every two years for average-risk men aged 50 to 69. The American Cancer Society also recommended annual PSA-based screening beginning at 45 for Black men and for men with a strong family history of prostate cancer, and it advised men between 70 and 74 to talk to their doctors about the pros and cons of getting tested.
The American Cancer Society said men with elevated PSA test results can discuss with their doctors any potential need for additional MRI testing, and the organization’s press release described PSA as a simple blood test that measures the level of prostate-specific antigen. The American Cancer Society’s update also set boundaries for when screening should stop, with the guidelines stating that men 75 and older, or those not expected to live another 10 years, should stop screening, and the press release adding that screening is not recommended for men aged 75 years and older.
Why the shift happened
The American Cancer Society said the guideline update reflects stronger evidence that PSA-based screening significantly reduces prostate cancer mortality and diagnosis of advanced-stage disease, and it tied the change to advances in approaches to an elevated PSA that can reduce the risk of adverse outcomes.
Dr. William Dahut, the ACS chief scientific officer, said in an interview released by ACS that "there is true evidence that prostate cancer screening with the PSA test, a blood test, can actually decrease one's chance of dying from prostate cancer."
Dr. Robert Smith, senior vice president for early cancer detection science and senior author of the report, said the PSA test is "just the first step in a screening process," and he described secondary testing for men with elevated PSA levels as determining who needs a biopsy.
The American Cancer Society’s guidance also emphasized harm reduction steps, with the press release describing clinicians ensuring patients understand the potential benefits, limitations, and harms before starting screening, and ABC News noting that risks include overdiagnoses and overtreatment.
Other groups and next steps
The American Cancer Society’s new guidance arrived as other U.S. groups continued to differ, with ABC News stating that the CDC and the U.S. Preventive Services Task Force do not explicitly recommend PSA testing at a specific age and that the American Academy of Family Physicians does not recommend PSA screening for prostate cancer at all.
ABC News also reported that the American College of Physicians recommends men discuss with their doctors the benefits and risks of screening, only recommending men between 50 and 69 years old get screened if they have a life expectancy of more than 10 to 15 years, while the American Urological Association recommends screening for men between 55 and 69 with a life expectancy of more than 10-15 years.
The American Cancer Society’s press release said its guideline update was published in CA: A Cancer Journal for Clinicians and described a systematic evidence review and a modeling study commissioned by the ACS.
ABC News added that any official changes to prostate cancer screening guidelines is expected to take years to get adopted, while the organization said many doctors follow ACS guidelines.