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July 2016

Improving Prostate Cancer Screening and DiagnosisHealth Policy and Biomarkers Beyond PSA

Author Affiliations
  • 1James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland
JAMA Oncol. 2016;2(7):867-868. doi:10.1001/jamaoncol.2016.0170

The initial goal of prostate cancer screening with prostate-specific antigen (PSA) was to identify men with early-stage disease according to the general oncologic principle of secondary prevention that early diagnosis and treatment would prevent disease progression and improve survival. However, 2 randomized clinical trials evaluating PSA screening and a large body of literature have identified unintended harms of overdiagnosis and overtreatment of potentially indolent prostate cancer.1,2 The revised US Preventive Services Task Force grade D recommendation for PSA screening in 2012, stating that there is a lack of evidence that its benefits outweigh its harms, further thrust prostate cancer screening into the spotlight of health policy in the United States.3

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