The U.S. Preventive Services Task Force has updated its guidelines regarding prostate cancer screenings in men. Now, people 70 or older who have not shown any signs of the disease are no longer discouraged from undergoing regular screenings and check their PSA levels.
Even after this update, some experts keep saying that when patients do get a positive test, many of them are not sure about what to do and that this is a problem that should be addressed by the task force and national health authorities.
The recent guideline concerning prostate cancer screening was presented by the teams back in 2012, and it strongly recommended against routinary searches of the prostate-specific antigen (or PSA) levels. They explained, in that opportunity, that the downsides of regular screenings outlined the benefits for the patient.
However, the latest updated guideline gives every patient (between 55 and 69 years old and with no symptoms or history of prostate cancer) the opportunity to decide whether they want regular screenings or not.
Now, the latest guideline upgrades the rating to C, which translates into the task force recommending a “decision up to a man’s values and preferences,” they wrote in an official press release this Wednesday. For men older than 70 years old, the D rating remains.
New studies make new guidelines
According to the task force, there is new information regarding prostate cancer that is changing all the body of recommendations from the organization. For example, new data has shown that most prostate cancer cases grow slowly or do not grow at all. Even the possibilities for a man to die after developing the disease are slight, the task force says.
“We were very concerned in 2012 that many, many men were being treated for prostate cancer. The balance has shifted, and now we can recommend that men have a conversation with their doctors about screening,” Dr. Kirsten Bibbins-Domingo, chairwoman of the task force, an independent panel of medical experts.
According to Bibbins- Domingo, several studies have proved PSA tests being very positive for the patients of most ages. In fact, recent information has even helped on the reduction of consequences for screenings like the avoiding of unnecessary biopsies and advanced treatments.
For example, a radiation treatment could translate into a bowel injury, urination problems and even impotence, so many patients could be confused about what they can do with a positive test. One of the objectives is also to avoid false-positive results as they can produce high anxiety levels in the patient along with money spending unnecessary procedures.
According to the task force, one of the studies helped them on the making of the new guideline was published back in last year’s October. A group of investigators proved that a personal doctor could, in fact, monitor the development of a prostate cancer disease (mostly through routinary PSA screenings) without the need of actually treating the illness.
According to that study, only 1 percent of men died of prostate cancer in the last decade, as there was not any difference between the ones who treated the disease and the ones that monitored it continuously. The authors of the research explained that it would take more than 25 surgeries including prostate removals to avoid just one case of the cancer being spread to other areas of the body.
Critics to the latest guideline: little agreement
After this Wednesday the Preventive Services Task Force presented its latest draft, many have shown its disconformity with the recommendations. The guidance is open for public debate until May 8.
Prostate cancer cases are known for raising the levels of PSA found in blood through screenings. However, this type of cancer is not the only thing that can generate a PSA rise, since several infections or even a benign enlargement of the prostate could do it. Because of this reason, many false-positive results could alarm patients unnecessarily, said Dr. Otis Brawley, chief medical officer of the American Cancer Society.
“Prostate screening has been a contentious issue ever since the prostate specific antigen test became available more than three decades ago. It literally misses as many prostate cancers as it finds,” Brawley said in a comment after the release of the draft.
Currently, in the U.S., prostate cancer is one of the most common types of cancer among men. According to the American Cancer Society, 13 percent of men will be diagnosed with prostate cancer at any time in their lifetimes. Last year, there were 180,000 cases of prostate cancer men and 28,000 reported deaths. Recent data has shown that prostate cancer is responsible for more than 4 percent of all cancer-related deaths in the country.