Does this mean I don’t need to worry about getting screened for prostate cancer?
No. It’s important to be vigilant for any cancer, and screening is the best way to detect tumors early and intervene if you need treatment.
The question is what screening method is best? Unfortunately, the USPSTF report doesn’t make clear. There are other tests doctors use to detect prostate cancer, including digital rectal exams and ultrasound, but the task force found that these weren’t effective in picking up cancers either.
If you’re a healthy middle-aged male, you should discuss with your doctor when you need to begin screening for prostate cancer. Your risk of the disease increases with age, so it may make sense to wait before you begin regular screening.
Will doctors immediately follow the task force’s recommendations?
That’s hard to say. Like the USPSTF’s mammogram guidelines, the new PSA recommendations are already stirring controversy. Many prostate cancer experts are concerned that the advice against not screening healthy men could result in more cases of prostate cancer. They note that since PSA screening became widespread in the 1990s, death rates from the disease have dropped. Calling the recommendation “counterproductive,” and “wrong,” they are hoping that the advice does not cause more men to die from the disease.
Critics of the recommendation also note that potential risks like incontinence or impotence are not necessary outcomes of biopsies or other treatments, and that any such harms pale in comparison to having cancer. It is because of PSA screening, they argue, that doctors now see fewer cases of advanced prostate cancer that has spread to other organs.
The problem is not the PSA test itself, many doctors say, but that better strategies for dealing with positive or negative results are needed. That would help men benefit more from screening.