By: Dr. Kenneth Berger, Board Certified Urologist, Lourdes Health
The United States Preventative Services Task Force (USPSTF) is a panel of non-practicing primary care providers and epidemiologists funded by the US Department of Health and Human Services to make recommendations on the effectiveness of various screening tests and interventions in primary care. Previously, in 2012, this panel made a recommendation against screening for prostate cancer with digital rectal examination (DRE) and PSA in all men who had not previously been screened. They made their decision without consulting experts, such as urologists, and without examining all of the studies available at the time. The decision was based in part upon past overtreatment of prostate cancer.
In 2017 they reviewed their prior 2012 recommendation regarding prostate cancer screening. They reviewed studies they had not previously reviewed and now heard testimony from experts in the field of Urology. The new 2017 draft recommendations encourage men 55 to 69 to discuss the risks and benefits of prostate cancer screening with their physician to determine their risk and whether screening is right for them.
It is important to remember that a PSA blood test, is not a test that tells us that a person has or does not have prostate cancer. It is simply a tool to be used with other tools, such as a digital rectal examination (DRE or feeling the prostate) that help us to decide whether to proceed to prostate biopsy which is the test that more definitively tells us whether someone has prostate cancer. Also, over time, we have become much better at determining the risk of an individual’s prostate cancer. There are many prostate cancers today, that we do not treat, but actively follow.
The take home message is that prostate cancer is a common cancer among men. The decision as to whether to be screened for prostate cancer is a personal decision. All men between 55-69 are encouraged to discuss prostate cancer screening with their primary care provider (PCP) or with their Urologist. Men outside of that age range may also wish to be screened depending upon a range of factors including overall health and family history.
It is also good to know that Washington State has legislation that requires insurers to cover prostate cancer screening if ordered by a health care provider. Talk to your health care provider. If you don’t have one, get one!