USPSTF Screening guidelines are being updated

[Cyclingrealtor]

Hello Cancer Brothers and Cancer Warriors -

The USPSTF - United States Preventive Services Task Force is making an update to the 2018 Prostate Cancer Screening Guidelines. There are many sections of the "public comments" section that you can share your opinion for the screening guideline updates. Hopefully you agree with better and more robust guidelines like women have for breast and cervical cancer screenings that are part of their yearly screening for free.

uspreventiveservicestaskfor...

We know that the USPSTF 2012 "D" recommendation of "Do not use prostate-specific antigen (PSA)–based screening for prostate cancer. Grade: D". Keck Medicine of USC study shows that the incidence rate of metastatic prostate cancer rose as much as 43% in men 75 and older and 41% in men 45-74 after routine prostate cancer screenings were no longer recommended.

The 2018 USPSTF recommendation of C / D were really of NO significance: Have a talk with your doc starting at age 55 to see if screening is right for you (most language bundles treatment risks and side effects with screening), "In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs".

While the over diagnosis and over treatment are true with the early days when 30 - 35% of the men being treated with prostatectomies were age 75+.

What is missing, in my opinion and I hope in many of yours, is the opportunity for regular screening starting at age 45. There are many great age stratified recommendations by many of the big teaching hospitals and also the NCCN - National Comprehensive Cancer Network.

One thing ALL agree on is that early detection of prostate cancer provides the greatest opportunity for treatment and possible cure.

Right now, men under 55 are an acceptable loss to the healthcare system but these men would most likely receive great benefit of early detection given a 25 - 40 year life span ahead.

I, myself, are part of the 2012 USPSTF disastrous recommendation that has backfired with the 41% increase of advanced disease at diagnosis. I was steered away from screening and not given the opportunity in 2014 - do not use psa testing for prostate cancer testing. I felt like I had dodged the bullet when I had no family history. The doc said that I may get it when I am much older in my 70's - 80's because of age. So he tested my testosterone level for early onset of ED and his conclusion "likely psychological" but did not factor in low libido, low testosterone, fatigue and I was in the best shape of my life (46) as I had just biked 3,600 about 4 months before. The simple psa test could have made a huge difference in my prostate cancer journey!

[NPfisherman]

Cr,

You are another case of "screwed by the system.." You wish to start screening at 45... I like 40 and 35 for those with a family history of aggressive prostate cancers....

Providers putting people on ADT only, despite all the proof of doublet therapy increasing OS and slowing time to MCRPC .... calling themselves your MD, and swearing to first do no harm...

Well, that's the greatest shuck of all...

Fish

[Cooolone]

Problematic with the skewed and steered questioning in regards to "Harm" without discussing "Benefit"... Obviously it's problematic to present only one side of things or steer questions one way. I responded to the survey, and there were a few questions that were completely obfuscating and also asking questions which a typical patient couldn't answer other than providing a non evidence based opinion... Interesting!

Bottom line, is PSA screening helpful or harmful? Asking only about harm, is an issue! But as an opinion, it is definitely beneficial, especially to those with family history.

Regards