USPSTF recommendation statement on screening for prostate cancer

Bottom Line: The U.S. Preventive Services Task Force (USPSTF) recommends that men 55 to 69 who are interested in screening talk to their doctors about potential benefits and harms of screening for prostate cancer before deciding whether to undergo periodic prostate-specific antigen (PSA)-based screening. The USPSTF recommends against PSA-based screening for men 70 and older.

Background: The USPSTF routinely makes recommendations about the effectiveness of preventive care services. This latest statement is an update of the 2012 recommendation. Prostate cancer is one of the most common types of cancer that affects men. Many men with prostate cancer never experience symptoms and, without screening, would never know they have the disease.

The USPSTF Concludes: For men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be an individual one and should include discussion of the potential benefits and harms of screening with their clinician. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men.

However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. 

In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening. (C recommendation) The USPSTF recommends against PSA-based screening for prostate cancer in men 70 years and older. (D recommendation)