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Viewpoint: Limiting Prostate Cancer Screening
- Richard M. Hoffman, MD, MPH
- From the New Mexico Veterans Affairs Health Care System and the Cancer Research and Treatment Center, University of New Mexico School of Medicine, Albuquerque, New Mexico.
Abstract
Prostate cancer screening is controversial, and major professional associations offer differing screening guidelines. The author addresses 3 key issues about prostate cancer screening: 1) the prostate-specific antigen (PSA) criteria to recommend a prostate biopsy, 2) the appropriate age to start screening, and 3) the appropriate age to stop screening. The author argues, on the basis of evidence published since 2000, that data supporting the efficacy of PSA screening remain unconvincing. The author recommends that screening should not be expanded to include average-risk men younger than age 50 years or older than age 75 years and that a PSA threshold below 4.0 ng/mL should not be used to trigger biopsy referral.
Article and Author Information
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Acknowledgments: The author thanks Michael J. Barry, MD, and Thomas D. Denberg, MD, for their helpful comments on earlier drafts of this manuscript.
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Grant Support: By the Department of Medicine, New Mexico Veterans Affairs Health Care System.
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Potential Financial Conflicts of Interest: Dr. Hoffman has given expert testimony on the subject of prostate cancer screening.
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Requests for Single Reprints: Richard M. Hoffman, MD, MPH, New Mexico VA Health Care System 111GIM, 1501 San Pedro Drive SE, Albuquerque, NM 87108; e-mail, rhoffman{at}unm.edu.
