The American College of Preventive Medicine (ACPM) has found there is insufficient evidence to recommend for or against routine population prostate screening with digital rectal examination (DRE) or measurement of the serum tumor marker, prostatespecific antigen (PSA). ACPM advises that clinicians caring for men, especially African-American men and those with a family history, should provide information about the potential benefits and harms of screening and limits of current evidence to allow for them to make an informed decision about screening.
According to Dr. Lionel Lim, the lead author of ACPM's recommendation, "Patient and clinician discussion about screening is important, however, a man should ultimately be allowed to make his own decision about screening while taking into consideration personal preferences and life expectancy. If the patient prefers to defer to the clinician or is unable to make a decision regarding screening, then testing should not be offered as long as the patient understands the associated benefits, potential limitations, and adverse effects."
Prostate cancer is the leading type of cancer among U.S. men, and the second leading cause of cancer deaths. While prostate cancer incidence increases with age, and men with a family history of prostate cancer and African-American men are at higher risk of both developing and dying from prostate cancer, there are both risks and benefits associated with prostate screening and further studies are needed to establish the efficacy and optimal age at which prostate cancer screening should be initiated in these high-risk population groups.
According to Dr. Michael Parkinson, President of ACPM, "Prostate cancer remains a significant concern among U.S. men today. ACPM will continue to review emerging evidence to determine and communicate the most effective methods to detect and prevent the disease."
ACPM's practice policy statement on screening for prostate cancer appears in the February 2008 issue of the American Journal of Preventive Medicine. The statement can be viewed at http://www.acpm.org/ProstateScreening_AJPM.pdf.
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