Prostate Cancer Advisory Council PSA Screening Position Statement
Response to the US Preventive Services Task Force’s Recommendation for PSA Screening

November 21, 2011

The State of Florida Prostate Cancer Advisory Council wishes to comment on the forthcoming U.S. Preventive Services Task Force recommendation that men should no longer be screened for prostate cancer. Prostate cancer is the leading cancer among Floridian men. With this stated, the Council acknowledges that PSA screening may lead to the over-treatment of non-clinically relevant prostate cancer tumors in the general population. However, when interpreted correctly, PSA testing, in combination with digital rectal examinations (DRE), provides valuable information that helps physicians assess cancer risk and predict disease progression. This information is especially relevant for high-risk populations, such as African American men and men with a family history of prostate cancer. Most men diagnosed with prostate cancer do not require immediate, active therapy, but a large number of aggressive and eventually lethal cancers would go undetected without PSA screening. The dilemma is that no reliable tests exist to date that allows for the differentiation of aggressive from non-aggressive cancer variants; thus more research addressing this important issue should be encouraged and funded as a national priority. Based on current evidence, the Council recommends that men age 50 years and older (age 40 for men at high risk) should be informed by their health care providers annually regarding the risks and benefits of PSA screening. Men diagnosed with prostate cancer should make informed decisions, in consultation with their treating physicians, as to the need for therapeutic interventions versus an active surveillance treatment plan that consists of continued PSA testing, DREs, and biopsies. The Council maintains that prostate cancer screening and early detection remain important components of responsible and personalized patient care in appropriately informed men and should be performed in those who request screening, and especially in men at high risk, or with no regular access to health care.

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