The federal working group softened its opposition to the usual cover for prostate cancer.
An influential federal working group is relaxing its controversial routine screening of prostate cancer.
Is put forward by the revised formula on Tuesday the U.S. preventive services task force said that men aged 55 to 69 should be alone with their doctor to decide whether and when to prostate specific antigen (PSA) test.
The task force will continue to recommend men aged 70 and over for PSA testing, saying the potential harm continues to outweigh the benefits of routine screening in this age group.
This is not yet finally decided to advice, waiting for the feedback from the public, is in special working group after five years, suggest that routine use of common blood tests method, struck many men and their doctors. The 2012 guidance prompted a significant drop in PSA testing.
The working group decided to adjust screening recommendations based on new research.
“The new evidence allows us to say, in a word, that the benefits now outweigh the risks,” said Dr. Kirsten bibbs-domingo, a professor of medicine at the university of California, San Francisco. She says the latest research also shows that screening can bring a little net benefit.
“So,” says bibbon-domingo, “we recommend that doctors and patients talk about screening for them.
Hazards include the stress of often causing painful and sometimes dangerous biopsies. Even if the test detects an actual malignancy, many prostate cancers grow so slowly that they will never be life-threatening. Still, many men receive surgery and radiotherapy, which may make them incontinent or ineffectual.
“PSA testing is not a good test,” says bibbs-domingo. “It doesn’t help us to differentiate between the types of cancers that are going to kill you and cancers that don’t progress over time, and that doesn’t lead to men’s health problems.”
As a result, when the panel issued its last guidelines in 2012, the panel concluded that the potential harm of screening was beyond the benefit.
But the group says the results of the past five years have changed the equation.
Specifically, the European prostate cancer screening randomized study (ERSPC) found that PSA testing reduced the risk of developing advanced prostate cancer by about 30 percent, and the risk of dying from disease by about 20 percent.
At the same time, according to a recent study, a growing number of men are skipping treatment for prostate cancer. Instead, they and their doctors are choosing to “watch out” or actively monitor a malignant tumor. The team says the less aggressive treatment can minimize the risk of screening.
Therefore, in the revision of the proposal, task force to give up for men aged between 55 and 69 PSA testing “D” Suggestions, replacing the ages with “C” advice for each of the men make a decision on whether to separate screening – consult his doctor.
Bibbins-Domingo stressed that the task force had stopped pressing all young people to check.
“Some men might say, ‘you know, I really want to avoid dying of prostate cancer, it is one of the most important for me, so even though there is little possibility of this happening, I also want to do,'” said Bibbins – Domingo. For every 1,000 screeners, screening saves about one or two lives.
“The risk of impotence or incontinence is also a reasonable option for some men,” says bibbon-domingo. “I don’t want to risk what might happen along the way.
Doctors who have long advocated active PSA testing have praised the new guidelines.
“I’m very happy,” said Dr. William Catalona, a professor of urology at northwestern university’s inberg school of medicine. “I think it’s a victory for PSA screening for prostate cancer.
“PSA tests can save lives,” he said. “The U.S. preventive services task force does not encourage PSA screening, has created a generation of family doctors and physicians, they think that PSA screening for patients is a bad thing, if this continues, we will lose all these benefits in reducing the mortality of prostate cancer. “He said he wanted the group to go further and advised doctors to actively encourage PSA screening from the age of 40 to 70.
Dr. David Penson, a urologist at vanderbilt-ingram cancer center, agreed with the task force. “The idea of letting ourselves decide is a great thing,” he said. He points out that the new guidelines are consistent with those of other medical groups.
But other doctors worry that the task force’s recommendations will be simplified as screening recommendations.
Dan Merenstein, a family medicine doctor at Georgetown University, believes the new evidence is not worth changing. He worries that the new guidelines are confusing.
Merenstein said: “I’m worried about is, rather than the discussion – because this is a difficult and lengthy discussion – the doctor just like they do a cholesterol test, just for the test.” “That would do more harm than good.”
At the same time, Dr. Otis Brawley, chief medical officer of the American cancer society, said the guidelines were in the right balance.
“I do think we do a lot of things in medicine with a pendulum,” brawley said. “On the pendulum may reach the right place, here we are aware of the dangers exist, there is profit, individuals need to measure these injuries and interest, and tailored suits own decision for them.”
You can also weigh in with the task force to seek public opinion on the new proposal.