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PSA test discussions should stress potential harms, ACP says

NEWS IN BRIEF — Posted April 15, 2013

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New guidelines encourage physicians to discuss the limited benefits and substantial harms of the prostate-specific antigen test with male patients age 50 to 69. Only men in that age group who express a clear preference for screening should receive a PSA test, said the guidance, which was issued by the American College of Physicians.

The recommendations were published in the April 9 issue of Annals of Internal Medicine. They include talking points for doctors to help them explain the benefits and harms of prostate cancer screening and treatment. Those potential harms include impotence, infection and urinary incontinence, the ACP said (link).

Although 16.7% of men will receive a diagnosis of prostate cancer in their lifetime, only 2.9% will eventually die of the disease, the guidance statement said. The ACP recommends against PSA testing in average-risk men who are younger than 50, older than 69, or who have a life expectancy of less than 10 to 15 years. The U.S. Preventive Services Task Force recommends against PSA-based screening for prostate cancer.

In developing its new recommendations, the ACP Clinical Guidelines Committee assessed four U.S. prostate cancer screening guidelines. The guidelines were issued by the American College of Preventive Medicine, the American Cancer Society, the American Urological Assn. and the task force.

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