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December 28, 2011

Prostate Cancer Screening—The Evidence, the Recommendations, and the Clinical Implications

Author Affiliations

Author Affiliations: Departments of Medicine and Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (Dr Chou); and Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia (Dr LeFevre).

JAMA. 2011;306(24):2721-2722. doi:10.1001/jama.2011.1891

On October 11, 2011, the US Preventive Services Task Force (USPSTF) released its draft recommendation on prostate cancer screening. In it, the USPSTF recommended for the first time against prostate cancer screening for men of all ages (a grade “D” recommendation). Predictably, this was met with considerable controversy.

The mission of the USPSTF is to improve the health of all persons in the United States by making evidence-based recommendations about clinical preventive services. Each USPSTF recommendation is based on a systematic review of the evidence.1 Before making a recommendation about a preventive service, the task force requires that the evidence be sufficient to estimate with at least moderate certainty the balance of benefits relative to harms.2 In this case, across the population of screened men, the USPSTF determined that benefits of prostate-specific antigen (PSA)–based screening for prostate cancer were outweighed by harms.