 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Digital rectal examination (DRE) and prostate-specific antigen (PSA) tests can find prostate cancer early, before symptoms develop. In DRE, a doctor inserts a finger into the patient's rectum to feel the prostate. A PSA test is a blood test. Very high PSA levels occur only with prostate cancer, but the more common intermediate levels also occur with benign prostate disease. Abnormal results on DRE or high PSA levels require prostate biopsy to see whether cancer is actually present. To perform the biopsy, doctors insert a hollow needle to obtain a piece of the prostate gland that can be examined under a microscope.
It is not known whether detection and treatment before symptoms develop are helpful to patients. In most cases, prostate cancer grows very slowly, so most men with early prostate cancer die of something else rather than of prostate cancer itself. Early detection, however, puts men at risk for unnecessary worry and side effects of treatment. Surgery and radiation therapy, common treatments for prostate cancer, can cause impotence and urinary leakage.
SUMMARIES FOR PATIENTS
Screening for Prostate Cancer: A Recommendation from the U.S. Preventive Services Task Force
3 December 2002 | Volume 137 Issue 11 | Page I-48
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full reports titled "Screening for Prostate Cancer: Recommendation and Rationale" and "Screening for Prostate Cancer: An Update of the Evidence for the U.S. Preventive Services Task Force." They are in the 3 December 2002 issue of Annals of Internal Medicine (volume 137, pages 915-916 and pages 917-929). The first report was written by the U.S. Preventive Services Task Force; the second report was written by R Harris and KN Lohr.
What is the U.S. Preventive Services Task Force?
The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews published research and makes recommendations about preventive health care.
What is the problem and what is known about it so far?
The prostate gland is an organ surrounding the tube that empties urine from the bladder. Its function is to add fluid and nutrients to semen, the fluid that carries sperm. Prostate cancer is the most common type of cancer and the second most common cause of cancer-related death in U.S. men. However, prostate cancer often grows slowly and never causes a problem.
How did the USPSTF develop these recommendations?
The USPSTF reviewed published research to measure the benefits and harms of screening for prostate cancer.
What did the authors find?
The USPSTF found good evidence that PSA testing can find early prostate cancer. The evidence suggests that PSA testing correctly identifies more men with prostate cancer than DRE. However, no good-quality evidence shows that finding prostate cancer early means that fewer men die of the disease. Men most likely to benefit if screening is effective are those who are 50 to 70 years of age and those who are older than 45 years of age and at higher risk for prostate cancer because they are African American or because they have a father or brother with prostate cancer.
What does the USPSTF suggest that patients do?
The USPSTF does not recommend for or against routine screening for prostate cancer using DRE or PSA testing. Men who are interested in screening for prostate cancer should discuss it with their doctors and, most important, should not be screened without first understanding the potential benefits and harms of early treatment.
What are the cautions related to these recommendations?
As better information about the positive and negative effects of early detection and treatment of prostate cancer becomes available, the USPSTF may revisit this issue.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  R. J. Coates, M. J. Khoury, M. Gwinn, C. E. Gartner, J. J. Barendregt, W. D. Hall, A. C. J.W. Janssens, C. M. van Duijn, G. Severi, G. B. Byrnes, et al. Five Genetic Variants Associated with Prostate Cancer N. Engl. J. Med., June 19, 2008; 358(25): 2738 - 2741. [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Williams-Piehota, L. A. McCormack, K. Treiman, and C. M. Bann Health information styles among participants in a prostate cancer screening informed decision-making intervention Health Educ. Res., June 1, 2008; 23(3): 440 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. A. Dhalla, T. Kiran, H. E. Golden, A. N. Trivedi, W. Rakowski, and J. Z. Ayanian Effect of cost sharing on screening mammography. N. Engl. J. Med., May 29, 2008; 358(22): 2411 - 2411. [Full Text] [PDF]
|
|
|
|
 |
|
 L. E. Ross, Z. Berkowitz, and D. U. Ekwueme Use of the Prostate-Specific Antigen Test among U.S. Men: Findings from the 2005 National Health Interview Survey Cancer Epidemiol. Biomarkers Prev., March 1, 2008; 17(3): 636 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Wong, J. R. Chapman, and J. C. Craig Cancer Screening in Renal Transplant Recipients: What Is the Evidence? Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(Supplement_2): S87 - S100. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Braillon Response J Natl Cancer Inst, February 6, 2008; 100(3): 222 - 223. [Full Text] [PDF]
|
|
|
|
 |
|
 W. R. Farwell, J. A. Linder, and A. K. Jha Trends in Prostate-Specific Antigen Testing From 1995 Through 2004 Arch Intern Med, December 10, 2007; 167(22): 2497 - 2502. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Starks and S. Brown Trinidad Choose Your Method: A Comparison of Phenomenology, Discourse Analysis, and Grounded Theory Qual Health Res, December 1, 2007; 17(10): 1372 - 1380. [Abstract] [PDF]
|
|
|
|
 |
|
 R. MacKenzie, S. Chapman, S. Holding, and K. McGeechan 'A matter of faith, not science': analysis of media coverage of prostate cancer screening in Australian news media 2003-2006 J R Soc Med, November 1, 2007; 100(11): 513 - 521. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Lilja, D. Ulmert, T. Bjork, C. Becker, A. M. Serio, J.-A. Nilsson, P.-A. Abrahamsson, A. J. Vickers, and G. Berglund Long-Term Prediction of Prostate Cancer Up to 25 Years Before Diagnosis of Prostate Cancer Using Prostate Kallikreins Measured at Age 44 to 50 Years J. Clin. Oncol., February 1, 2007; 25(4): 431 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Knudsen, P. M. McMahon, and G. S. Gazelle Use of Modeling to Evaluate the Cost-Effectiveness of Cancer Screening Programs J. Clin. Oncol., January 10, 2007; 25(2): 203 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Albertsen PSA Testing: Public Policy or Private Penchant? JAMA, November 15, 2006; 296(19): 2371 - 2373. [Full Text] [PDF]
|
|
|
|
 |
|
 J. T. Ferrucci Double-contrast barium enema: use in practice and implications for CT colonography. Am. J. Roentgenol., July 1, 2006; 187(1): 170 - 173. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Hoffman Viewpoint: limiting prostate cancer screening. Ann Intern Med, March 21, 2006; 144(6): 438 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. K. Gwede and R. J. McDermott Prostate Cancer Screening Decision Making Under Controversy: Implications for Health Promotion Practice Health Promot Pract, January 1, 2006; 7(1): 134 - 146. [Abstract] [PDF]
|
|
|
|
|
|
H. C. Sox and C. Mulrow An Editorial Update: Should Benefits of Radical Prostatectomy Affect the Decision To Screen for Early Prostate Cancer? Ann Intern Med, August 2, 2005; 143(3): 232 - 233. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Atkins, J. Siegel, and J. Slutsky Making Policy When The Evidence Is In Dispute Health Aff., January 1, 2005; 24(1): 102 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J. Murff, D. R. Spigel, and S. Syngal Does This Patient Have a Family History of Cancer?: An Evidence-Based Analysis of the Accuracy of Family Cancer History JAMA, September 22, 2004; 292(12): 1480 - 1489. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. C. Y. Chan, S. W. Vernon, C. Ahn, and A. Greisinger Do Men Know That They Have Had a Prostate-Specific Antigen Test? Accuracy of Self-Reports of Testing at 2 Sites Am J Public Health, August 1, 2004; 94(8): 1336 - 1338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. S. Morales, J. Rogowski, V. A. Freedman, S. L. Wickstrom, J. L. Adams, and J. J. Escarce Use of Preventive Services by Men Enrolled in Medicare+Choice Plans Am J Public Health, May 1, 2004; 94(5): 796 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. J. S. Kunkel, B. Meyer, C. Daskalakis, J. Cocroft, K. Jennings-Dozier, and R. E. Myers Behaviors Used by Men to Protect Themselves against Prostate Cancer Cancer Epidemiol. Biomarkers Prev., January 1, 2004; 13(1): 78 - 86. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. B. Martin, D. R. Gifford, M. E. Wright, A. Keller, E. Yi, D. R. Goodlett, R. Aebersold, and P. S. Nelson Quantitative Proteomic Analysis of Proteins Released by Neoplastic Prostate Epithelium Cancer Res., January 1, 2004; 64(1): 347 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Smith Screening for Prostate Cancer Ann Intern Med, September 16, 2003; 139(6): 531 - 531. [Full Text] [PDF]
|
|
|
|
|
|
H. T. Robertson Screening for Prostate Cancer Ann Intern Med, September 16, 2003; 139(6): 531 - 532. [Full Text] [PDF]
|
|
|
|
|
|
J. V.L. Sheffield and E. B. Larson Update in General Internal Medicine Ann Intern Med, August 19, 2003; 139(4): 285 - 293. [Full Text] [PDF]
|
|
|
|
 |
|
 M Mokete, A R Palmer, and K J O'Flynn High result in prostate specific antigen test BMJ, August 16, 2003; 327(7411): 379 - 379. [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. Sorum, J. Shim, G. Chasseigne, S. Bonnin-Scaon, J. Cogneau, and E. Mullet Why do Primary Care Physicians in the United States and France Order Prostate-Specific Antigen Tests for Asymptomatic Patients? Med Decis Making, July 1, 2003; 23(4): 301 - 313. [Abstract] [PDF]
|
|
|
|
|
|
E. C. Y. Chan, S. W. Vernon, F. T. O'Donnell, C. Ahn, A. Greisinger, and D. W. Aga Informed Consent for Cancer Screening With Prostate-Specific Antigen: How Well Are Men Getting the Message? Am J Public Health, May 1, 2003; 93(5): 779 - 785. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Screening for Prostate Cancer: Insufficient Evidence Journal Watch (General), January 10, 2003; 2003(110): 1 - 1. [Full Text]
|
|
|
Article
