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December 28, 2011

Grading the New US Preventive Services Task Force Prostate Cancer Screening Recommendation

Author Affiliations
Author Affiliations: Department of General Internal Medicine, Division of General Internal Medicine, University of Texas MD Anderson Cancer Center, Houston (Dr Volk); Division of Medicine, Geriatrics, and Palliative Care, Department of Medicine, University of Virginia School of Medicine, Charlottesville (Dr Wolf).
JAMA. 2011;306(24):2715-2716. doi:10.1001/jama.2011.1893

On October 11, 2011, the US Preventive Services Task Force (USPSTF) issued for public comment a draft recommendation statement regarding screening for prostate cancer.1 The public comment period is a new step taken by the USPSTF prior to finalizing its recommendation statements to help make its recommendations clearer and more useful to primary care providers. In taking this step, the task force signaled its intention to change its 2008 recommendation from a grade I statement (the current evidence is insufficient to assess the balance of the benefits and harms of the service) to a grade D recommendation—“The US Preventive Services Task Force . . . recommends against prostate-specific antigen (PSA)-based screening for prostate cancer.” Following an updated review of the evidence, the USPSTF concluded that there is moderate certainty that the harms of PSA-based screening for prostate cancer outweigh the benefits. The reaction from the media to the impending change has been swift, and organizations that support screening for prostate cancer in general have criticized the new recommendation. Is this reaction justified?