Post by Tony Crispino on Jan 27, 2015 19:50:22 GMT -8
Interesting abstract assessing the USPSTF recommendation to stop screening all men for prostate cancer.
Abstract Assessing the Affects of screening after the USPSTF Grade D Recommendation
It is completely unsurprising that the recommendation has had little effect at all on the practice of screening. Here are two key take home messages outlined in the piece:
> Studying 400 men referred to a tertiary center before and after the 2012 USPSTF recommendations, the authors found that the statement has not affected the clinical characteristics of patients referred to a tertiary center for elevated PSA levels. The study also found that urologists ordered significantly more PCA3 and repeat PSA tests and recommended fewer biopsies at the initial visit following the 2012 recommendation.
> Following the 2012 PSA recommendation statement, the patient population at tertiary centers for elevated PSA levels has not changed. However, urologists are using PCA3 and repeat PSA testing more frequently for patients with an elevated PSA level.
This was interesting the movement towards the PCA3 test but recently that test has been under fire a bit as not a game changing test. I believe that the more frequent "retesting" of PSA has been a good thing. Today more than ever before retesting and delayed approaches has been effective in better gauging disease aggressiveness, but it has not curbed biopsies. This does not surprise me either. I wonder the number of men that would have been biopsied once, discovered prostate cancer and went straight to therapy versus delayed treatment and re-biopsied a year later, or more. Thus Biopsies would be higher in occurrence in an AS case versus an immediate treatment case.
Just food for thought...
The full text is attached here...
Abstract Assessing the Affects of screening after the USPSTF Grade D Recommendation
It is completely unsurprising that the recommendation has had little effect at all on the practice of screening. Here are two key take home messages outlined in the piece:
> Studying 400 men referred to a tertiary center before and after the 2012 USPSTF recommendations, the authors found that the statement has not affected the clinical characteristics of patients referred to a tertiary center for elevated PSA levels. The study also found that urologists ordered significantly more PCA3 and repeat PSA tests and recommended fewer biopsies at the initial visit following the 2012 recommendation.
> Following the 2012 PSA recommendation statement, the patient population at tertiary centers for elevated PSA levels has not changed. However, urologists are using PCA3 and repeat PSA testing more frequently for patients with an elevated PSA level.
This was interesting the movement towards the PCA3 test but recently that test has been under fire a bit as not a game changing test. I believe that the more frequent "retesting" of PSA has been a good thing. Today more than ever before retesting and delayed approaches has been effective in better gauging disease aggressiveness, but it has not curbed biopsies. This does not surprise me either. I wonder the number of men that would have been biopsied once, discovered prostate cancer and went straight to therapy versus delayed treatment and re-biopsied a year later, or more. Thus Biopsies would be higher in occurrence in an AS case versus an immediate treatment case.
Just food for thought...
The full text is attached here...
