Men ages 55 to 69 who are considering prostate cancer screening should talk with their doctors about the benefits and harms of testing and proceed based on their personal values and preferences, according to a new clinical practice guideline released by the American Urological Association (AUA). The new guideline, which updates the Association’s 2009 Best Practice Statement on prostate-specific antigen (PSA) was announced during the 2013 AUA Annual Meeting in San Diego. The guideline does not address detection of prostate cancer in symptomatic men, where symptoms imply those that could be related to locally advanced or metastatic prostate cancer.
The new guideline is significantly different from previous guidance as it was developed using evidence from a systematic literature review rather than consensus opinion, provides rating and interpretation of the evidence based on randomized controlled trials with modeled and population data as supporting evidence, and develops statements that do not go beyond the available evidence. In developing the guideline, the panel acknowledged that ongoing research may lead to changes in the guidelines statements, and announced plans to update the guidelines regularly based on new evidence.
The guideline makes the following specific statements: