Don’t routinely perform PSA-based screening for prostate cancer.
More than 1,000 symptom-free men need to be screened for prostate cancer in order to save one additional life. As a result, increased harms and medical costs due to widespread screening of asymptomatic men are believed to outweigh the benefits of routine screening. There is a high likelihood of having a false positive result leading to worry, decreased quality of life and unnecessary biopsies when many of these elevated PSAs are caused by enlarged prostates and infection instead of cancer. This recommendation pertains to the routine screening of most men. In rare circumstances, such as a strong family history of prostate and related cancers, screening may be appropriate.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
The American College of Preventive Medicine (ACPM) Prevention Practice Committee (PPC), responsible for practice guidelines and statements from the College, created a Choosing Wisely task force to lead the development of these recommendations. Task force members consist of select PPC members and additional ACPM members solicited through ACPM’s bi-weekly e-newsletter, Headlines. Each task force member individually developed 2-3 recommendations and the top ten were selected using an electronic survey by the entire task force. Subsequently, the ten recommendations were prioritized by the task force and rationales with references were produced. These recommendations were presented to the entire PPC for consideration and prioritization of the top five. The top recommendations were selected and rationales revised and presented to the ACPM Board of Regents for final approval.
ACPM’s disclosure and COI procedures can be found at www.acpm.org.
Lim LS, Sherin K; ACPM Prevention Practice Committee. Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. Am J Prev Med. 2008 Feb;34(2):164-70.
Moyer; U.S Preventive Services Task Force. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012 Jul 17;157(2):120-34.
Qaseem A, Barry MJ, Denberg TD, Owens DK, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Screening for prostate cancer: a guidance statement from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2013 May 21;158(10):761-9.