Of note, USPSTF comes out rather strongly, almost heavy handily against screening, not even making any suggestion to discuss risks, benefits & alternatives with one's patients. Just prior to the conference (but after the presentation deadline had passed), the American College of Physicians published early online in Annals of Internal Medicine their clinical guidelines suggesting that physicians inform 50-69yo men of the risks, benefits & alternatives to screening for prostate cancer. The ACP did not recommend screening average-risk men younger than 50yo or older than 69yo. Furthermore, the ACP also did not recommend screening those with life expectancy less than 10-15yrs.
Most recently, the American Urological Association tossed their hat into the guideline arena but in a very nuanced fashion . The AUA recommends against screening w/PSA in men younger than 40yo but "does not recommend routine screening" in those 40-54yo. And for men 55-69yo, the AUA "strongly recommends shared decision making". In those who still desired screening, the AUA also came out in favor of testing every 2 years rather than annually.
So what are we supposed to do? Make no mention or offer at any age? Set aside even more precious time to discuss the above in detail? And if the latter, at which age group would you start? There's no single right answer for every provider so read the guidelines for yourself and come to your own decision.
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