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December 28, 2011

Prostate Cancer Screening—Time to Abandon One-Size-Fits-All Approach?

Author Affiliations

Author Affiliations: Departments of Genitourinary Medical Oncology (Dr Kim) and Urology (Dr Davis), University of Texas MD Anderson Cancer Center, Houston.

JAMA. 2011;306(24):2717-2718. doi:10.1001/jama.2011.1881

The new US Preventive Services Task Force draft recommendations discourage use of prostate-specific antigen (PSA) screening among asymptomatic men, regardless of age, race, or family medical history.1 This one-size-fits-all recommendation derives from the overdiagnosis and overtreatment of many patients with PSA-screened asymptomatic prostate cancer; it cites a “statistically insignificant 0.06% absolute reduction in prostate cancer–specific deaths for men aged 50 to 74 years”1 after a median of 9 years in the European Randomized Study of Screening for Prostate Cancer.2 But is the current evidence sufficient to discourage PSA screening in asymptomatic men and ultimately remove PSA screening from optional testing if Medicare or third-party payers adopt the task force's recommendation?