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American Cancer Society Updates Prostate Cancer Screening Guidelines

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In Short: The American Cancer Society (ACS) has updated its guidelines for prostate cancer screening, recommending that men aged 50 to 69 undergo regular screening using a blood test every two years.

American Cancer Society updates prostate cancer screening guidelines
YouTube — CBS19

American Cancer Society updates prostate cancer screening guidelines. CBS19

The American Cancer Society (ACS) has updated its guidelines for prostate cancer screening, recommending that men aged 50 to 69 undergo regular screening using a blood test every two years. This change reflects new evidence showing that screening can reduce the risk of dying from prostate cancer, according to the ACS's new recommendations released Thursday.

The updated guidelines diverge from earlier recommendations that left the decision about screening to patients and physicians based on careful consideration of risks and benefits. The ACS now strongly recommends that most men aged 50 and older should take a prostate-specific antigen (PSA) blood test every two years until age 70, while higher-risk men should start as early as age 45.

The new guidelines also advise that men with a higher risk, such as Black men and those with a significant family history of prostate cancer, should get tested annually starting at age 45. This is a significant shift from the previous guidelines, which made no universal recommendations for routine screening.

The ACS's updated guidelines are based on new evidence since 2010 that shows screening saves lives and that advances in case management can avoid the concerning harms from overdiagnosis and overtreatment. The organization emphasizes the importance of a doctor-patient conversation about the pros and cons of screening, especially for men aged 70 to 74, who should consult their doctor on continuing screening.

The National Screening Committee in the UK, which advises governments across the UK, has taken a different stance, stating that a screening program for all men is not justified. The committee advises that screening could cause more harm than good for most men, as many prostate cancers grow so slowly that they pose no threat until a person reaches 120-150 years old, according to the committee.

In the US, the U.S. Preventative Services Task Force has also updated its controversial 2012 recommendation to abandon routine screening of all men using the PSA test. A urologist who has treated prostate cancer patients for 17 years noted that the 2012 controversies led to significant confusion among both physicians and patients, and 65 percent of physicians stopped performing digital prostate examinations, abandoning any form of prostate cancer screening.

The ACS's new guidelines also address the issue of early diagnosis and treatment for prostate cancer, which is the most common cancer in men and kills approximately 12,000 people across the UK each year. The organization hopes that increased surveillance will reduce the number of Black patients presenting with cancers at advanced stages, as this demographic is disproportionately represented in prostate cancer mortality.

The new guidelines recommend that men discuss their individual risk factors, the potential benefits and limitations of screening, and the appropriate screening schedule with their physician. This includes secondary testing, such as MRI and biomarker testing, for men with an elevated PSA to help determine whether a prostate biopsy is necessary.

What this adds

The updated guidelines aim to provide clearer and more consistent advice for men regarding prostate cancer screening, addressing the complexities and controversies surrounding the issue.

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