The American Society for Radiation Oncology (ASTRO) applauds the U.S. Preventive Services Task Force (USPSTF) for addressing the use of prostate-specific antigen (PSA)-based screening for prostate cancer but cautions against a blanket no-testing policy.

Prostate cancer is the most commonly diagnosed cancer in men and more than 33,000 men die each year from this disease. PSA-based screening is associated with the detection of more prostate cancers and many patients benefit from PSA screening.

The USPSTF recommends against PSA-based screening, indicating there is a moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. ASTRO acknowledges that PSA screening isn't a perfect method of detecting prostate cancer. However, many patients' lives are saved by catching their prostate cancer early, and over the last 30 years we have achieved a 30 percent decline in the death rate from prostate cancer due in part to better screening.

"The problem with prostate cancer is not finding the cancer but in knowing when to treat and when not to treat," Leonard L. Gunderson, MD, MS, FASTRO, ASTRO chairman, said. "The USPSTF is correct in addressing the issue of over screening but is wrong to take the option completely off the table."

The decision to screen is a decision that ultimately should be made between the patient and the physician. It should be tailored around the patient's medical history and known risk factors—something a physician is best equipped to do. Together, the patient and physician should use screening results to discuss all treatment options—including watchful waiting.

"Physicians need to be able to provide their patients with the best options for maintaining their health. If PSA screening is the best option, then a physician should be able todecide that," Anthony L. Zietman, MD, FASTRO, ASTRO immediate past chairman and prostate expert, said.

Source: ASTRO