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Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.

Abstract In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of dying of prostate cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease. African American men and men with a family history of prostate cancer have an increased risk of prostate cancer compared with other men.
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Authors

Mayor MeshTerms
Keywords
Journal Title jama
Publication Year Start




PMID- 29801017
OWN - NLM
STAT- MEDLINE
DCOM- 20180607
LR  - 20180607
IS  - 1538-3598 (Electronic)
IS  - 0098-7484 (Linking)
VI  - 319
IP  - 18
DP  - 2018 May 8
TI  - Screening for Prostate Cancer: US Preventive Services Task Force Recommendation
      Statement.
PG  - 1901-1913
LID - 10.1001/jama.2018.3710 [doi]
AB  - Importance: In the United States, the lifetime risk of being diagnosed with
      prostate cancer is approximately 13%, and the lifetime risk of dying of prostate 
      cancer is 2.5%. The median age of death from prostate cancer is 80 years. Many
      men with prostate cancer never experience symptoms and, without screening, would 
      never know they have the disease. African American men and men with a family
      history of prostate cancer have an increased risk of prostate cancer compared
      with other men. Objective: To update the 2012 US Preventive Services Task Force
      (USPSTF) recommendation on prostate-specific antigen (PSA)-based screening for
      prostate cancer. Evidence Review: The USPSTF reviewed the evidence on the
      benefits and harms of PSA-based screening for prostate cancer and subsequent
      treatment of screen-detected prostate cancer. The USPSTF also commissioned a
      review of existing decision analysis models and the overdiagnosis rate of
      PSA-based screening. The reviews also examined the benefits and harms of
      PSA-based screening in patient subpopulations at higher risk of prostate cancer, 
      including older men, African American men, and men with a family history of
      prostate cancer. Findings: Adequate evidence from randomized clinical trials
      shows that PSA-based screening programs in men aged 55 to 69 years may prevent
      approximately 1.3 deaths from prostate cancer over approximately 13 years per
      1000 men screened. Screening programs may also prevent approximately 3 cases of
      metastatic prostate cancer per 1000 men screened. Potential harms of screening
      include frequent false-positive results and psychological harms. Harms of
      prostate cancer treatment include erectile dysfunction, urinary incontinence, and
      bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop
      long-term urinary incontinence, and 2 in 3 men will experience long-term erectile
      dysfunction. Adequate evidence shows that the harms of screening in men older
      than 70 years are at least moderate and greater than in younger men because of
      increased risk of false-positive results, diagnostic harms from biopsies, and
      harms from treatment. The USPSTF concludes with moderate certainty that the net
      benefit of PSA-based screening for prostate cancer in men aged 55 to 69 years is 
      small for some men. How each man weighs specific benefits and harms will
      determine whether the overall net benefit is small. The USPSTF concludes with
      moderate certainty that the potential benefits of PSA-based screening for
      prostate cancer in men 70 years and older do not outweigh the expected harms.
      Conclusions and Recommendation: For men aged 55 to 69 years, the decision to
      undergo periodic PSA-based screening for prostate cancer should be an individual 
      one and should include discussion of the potential benefits and harms of
      screening with their clinician. Screening offers a small potential benefit of
      reducing the chance of death from prostate cancer in some men. However, many men 
      will experience potential harms of screening, including false-positive results
      that require additional testing and possible prostate biopsy; overdiagnosis and
      overtreatment; and treatment complications, such as incontinence and erectile
      dysfunction. In determining whether this service is appropriate in individual
      cases, patients and clinicians should consider the balance of benefits and harms 
      on the basis of family history, race/ethnicity, comorbid medical conditions,
      patient values about the benefits and harms of screening and treatment-specific
      outcomes, and other health needs. Clinicians should not screen men who do not
      express a preference for screening. (C recommendation) The USPSTF recommends
      against PSA-based screening for prostate cancer in men 70 years and older. (D
      recommendation).
CN  - US Preventive Services Task Force
FAU - Grossman, David C
AU  - Grossman DC
AD  - Kaiser Permanente Washington Health Research Institute, Seattle.
FAU - Curry, Susan J
AU  - Curry SJ
AD  - University of Iowa, Iowa City.
FAU - Owens, Douglas K
AU  - Owens DK
AD  - Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
AD  - Stanford University, Stanford, California.
FAU - Bibbins-Domingo, Kirsten
AU  - Bibbins-Domingo K
AD  - University of California, San Francisco.
FAU - Caughey, Aaron B
AU  - Caughey AB
AD  - Oregon Health & Science University, Portland.
FAU - Davidson, Karina W
AU  - Davidson KW
AD  - Columbia University, New York, New York.
FAU - Doubeni, Chyke A
AU  - Doubeni CA
AD  - University of Pennsylvania, Philadelphia.
FAU - Ebell, Mark
AU  - Ebell M
AD  - University of Georgia, Athens.
FAU - Epling, John W Jr
AU  - Epling JW Jr
AD  - Virginia Tech Carilion School of Medicine, Roanoke.
FAU - Kemper, Alex R
AU  - Kemper AR
AD  - Nationwide Children's Hospital, Columbus, Ohio.
FAU - Krist, Alex H
AU  - Krist AH
AD  - Fairfax Family Practice Residency, Fairfax, Virginia.
AD  - Virginia Commonwealth University, Richmond.
FAU - Kubik, Martha
AU  - Kubik M
AD  - Temple University, Philadelphia, Pennsylvania.
FAU - Landefeld, C Seth
AU  - Landefeld CS
AD  - University of Alabama at Birmingham.
FAU - Mangione, Carol M
AU  - Mangione CM
AD  - University of California, Los Angeles.
FAU - Silverstein, Michael
AU  - Silverstein M
AD  - Boston University, Boston, Massachusetts.
FAU - Simon, Melissa A
AU  - Simon MA
AD  - Northwestern University, Evanston, Illinois.
FAU - Siu, Albert L
AU  - Siu AL
AD  - Icahn School of Medicine at Mount Sinai, New York, New York.
AD  - James J. Peters Veterans Affairs Medical Center, Bronx, New York.
FAU - Tseng, Chien-Wen
AU  - Tseng CW
AD  - University of Hawaii, Honolulu.
AD  - Pacific Health Research and Education Institute, Honolulu, Hawaii.
LA  - eng
PT  - Journal Article
PT  - Practice Guideline
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - JAMA
JT  - JAMA
JID - 7501160
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - AIM
SB  - IM
CIN - JAMA. 2018 May 8;319(18):1866-1868. PMID: 29800999
SPIN- JAMA. 2018 May 8;319(18):1946. PMID: 29801013
MH  - Age Factors
MH  - Aged
MH  - Early Detection of Cancer/adverse effects/methods/*standards
MH  - False Positive Reactions
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*diagnosis/therapy
MH  - Risk Assessment
MH  - Risk Factors
EDAT- 2018/05/26 06:00
MHDA- 2018/06/08 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/08 06:00 [medline]
AID - 2680553 [pii]
AID - 10.1001/jama.2018.3710 [doi]
PST - ppublish
SO  - JAMA. 2018 May 8;319(18):1901-1913. doi: 10.1001/jama.2018.3710.