AUA Clarifies Position on Prostate Cancer Screening

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Responding to recent news reports disparaging prostate cancer testing, the American Urological Association (AUA) issued a statement to clarify its recommendations for this testing.

“The AUA strongly supports early prostate cancer detection and feels it is in a man's best interest to consider being tested for prostate cancer,” said AUA Past President John M. Barry, MD.

The AUA statement is meant to address conflicting information regarding prostate cancer screening, and was issued following a recent New York Times article about the American Cancer Society changing its guidelines on managing prostate and other cancers.

On its web site, ACS reports that no major groups support routine testing and suggests that men should talk to their doctors starting at age 50. The AUA recommends that prostate cancer testing be individualized for each man, and men should consider testing beginning at age 40.

“The AUA strongly supports informed consent, including a discussion about the benefits and risks of testing, before screening is undertaken,” Dr. Barry said.

Prior to the emergence of PSA testing, only 68% of newly diagnosed men had localized tumors and 21% had metastatic disease, according to the AUA. Today, more than 90% of these men have localized tumors and only 4% metastatic disease.

“The controversy over prostate cancer should not surround the test, Dr. Barry said, “but rather how test results influence the decision to treat. The decision to proceed to prostate biopsy should be based not only on elevated PSA and/or abnormal DRE results, but should take into account multiple factors including free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity, prior biopsy history and comorbidities."

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