Men: Discuss PSA Testing with Your Doctor

Make a decision based on your situation, advises Norris Cotton Cancer Center

New federal draft guidelines issued by the U.S. Preventive Services Task Force (USPSTF) that question the necessity of PSA testing for prostate cancer in men should be assessed by men in discussion with their physicians.

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That is the recommendation of Norris Cotton Cancer Center (NCCC), the largest cancer center in northern New England and the only one that is a Comprehensive Cancer Center, as designated by the National Cancer Institute.

According to Mark Israel, MD, Director of NCCC, the draft guidelines are the natural result when science drives medical care.

"We are lucky that thoughtful people have looked at the entire body of information regarding prostate-specific antigen (PSA) testing and have made a recommendation," said Dr. Israel, responding to recent media reports on the Task Force's draft recommendation, which was issued Oct. 6. "But it's also important for individuals to make a determination of what's right for them in consultation with their own physician—the person who knows their medical case history best and who is familiar with the latest information about the pros and cons of screening."

Prostate cancer is the most common form of cancer among men, with approximately 30,000 men dying from the disease each year. According to the USPSTF, which makes recommendations about the effectiveness of specific clinical preventive services for patients without related signs or symptoms, "lifetime risk of diagnosis" for prostate cancer is currently estimated at 15.9%, or approximately 1 in 6. "Most cases of prostate cancer have a good prognosis," noted the USPSTF in its draft statement, "but some are aggressive; the lifetime risk of dying from prostate cancer is 2.8%."

Reports on the Task Force's draft guideline have appeared in the New York Times, Los Angeles Times, USA Today, and CNN, among hundreds of media and Internet information outlets.

John Seigne, MB, director of the Prostate and Genitourinary Cancer Programs at NCCC, emphasized the importance of informed choice for patients. "Where there is medical uncertainty and debate between experts about the best course of action, I believe that providing the patient with the tools to make an informed choice that is consistent with their personal values is the best course of action," he said. "That is why we have a Center for Shared Decision making at Dartmouth-Hitchcock Medical Center, and that is why we have our informational Decision Aids to provide to men who are considering getting a PSA test."

October 11, 2011