PSA Screening and the USPSTF Understanding the Controversy

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "PSA Screening and the USPSTF Understanding the Controversy"

Transcription

1 PSA Screening and the USPSTF Understanding the Controversy Peter C. Albertsen Division of Urology University of Connecticut Farmington, CT, USA USPSTF Final Report 1

2 Four Key Questions 1. Does PSA based screening decrease prostatecancer specific or all-cause mortality? 2. What are the harms of PSA based screening for prostate cancer? 3. What are the benefits of treatment of early stage or screen detected prostate cancer? 4. What are the harms of treatment of early stage or screen detected prostate cancer? Does PSA Screening Decrease Prostate Cancer or All Cause Mortality? 2

3 PLCO Trial PLCO Trial After 7 years of follow up of 76,693 men 50 prostate cancer deaths in screened group 44 deaths in control group 3

4 ERSPC Study Lancet August, Year Outcome 1-2 Patients /1000 { 4

5 Mortality Rate by Age at Diagnosis Prostate Cancer Mortality at 13 Years 5

6 Percent of Patients Diagnosed with Prostate Cancer after 11 Years 2.5% Control Screened 6.0% 9.6% No Cancer Low Risk Inter Risk High Risk M1 or PSA 0% 20% 40% 60% 80% 100% 5.8% Percent of Patients Dying from Prostate Cancer After 11 Years Control 0.431% Screened All Patients Dead of Prostate Cancer 0.336% 0% 50% 100% 6

7 Figure used by ASCO to demonstrate increased incidence from PSA testing Figure used by ASCO to demonstrate number of lives saved by PSA testing 7

8 Results impacted most by Sweden Swedish Randomized Trial 8

9 Hugosson et al Lancet Oncology 2010 Percent of Patients Diagnosed with Prostate Cancer after 14 Years Control 5.0% Screened 5.7% No Cancer Gleason 2-6 Gleason % 20% 40% 60% 80% 100% 9

10 Percent of Patients Dying from Prostate Cancer After 14 Years Control 0.784% Screened All Patients Dead of Prostate Cancer 0.442% 0% 50% 100% Prostate Cancer Mortality in 2005 Italy (2003) Spain USA Canada (2004) France Switzerland Finland Netherlands Sweden 55 : 64 years 65 : 74 years Mortality rate per person-years 10

11 Platinum Slide Series (a) Most commonly diagnosed cancer among men worldwide, 2008; (b) leading cause of cancer deaths among men worldwide, Source: GLOBOCAN 2008 [1]. 1/3 Melissa M. Center et al. Eur Urol 2012;6: What are the Harms of PSA Based Screening for Prostate Cancer? 11

12 Harms of Screening 76% of prostate biopsies showed no cancer 12% of men received at least one false positive result after 3 rounds of testing 3.5% of men developed fever post biopsy 0.4% experienced urinary retention 0.5% required hospitalization Figure used by ASCO to demonstrate morbidity from prostate biopsy 12

13 What are the Benefits of Treatment of Early Stage Prostate Cancer? PIVOT Trial 13

14 All Cause and Prostate Specific Mortality Scandinavian Prostate Cancer Group 4 March 5,

15 Prostate Cancer Mortality at 18 Years Prostate Cancer Mortality Men with Gleason 7 Benefit Most 15

16 Trial Results after 18 Years ProtecT trial Results Next Year Lancet Oncology 2014; 15:

17 Largest Randomized Trial of Prostate Cancer Treatment Ever Conducted 17

18 What are the Harms of Treatment of Early Stage Prostate Cancer? 18

19 USPSTF Recommendations 19

20 20

21 Challenges Going Forward: USPSTF Has Challenged Us to Improve Our Screening Algorithm 21

22 Organized Bi-annual Screening vs. Unorganized Screening Limit Screening to Men with Elevated PSA s at Baseline 22

23 Target Younger Men (55-59); Limit Screening Older Men (65-72) J Natl Cancer Inst 2015; 107:dju366 23

24 Improving PSA Specificity J Urol 2015;193: Prostate Health Index vs. %Free PSA 24

25 Prostate Cancer Treatment Growing Role for Active Surveillance Long Term Follow Up Data 25

26 Long Term Results Excellent for Properly Selected Patients Disease Prognostication: What is the Role for Genetic Markers? 26

27 Validating Genomics Tests Tests Costly Value Still Being Debated 27

28 What is the Role for MRI in Diagnosis and Monitoring Localized Disease? Office Prostate Ultrasound Needs to be Supplemented by MRI Images JAMA 2015; 313:

29 Moore & colleagues Conclusion 29

30 Summary PSA Testing Can Reduce Prostate Cancer Mortality PSA Testing Comes at a Price Over-diagnosis of Disease Diagnostic and Treatment Related Complications If You Decide to be Screened Be Sure Your PSA Elevation is Confirmed Before Agreeing to a Biopsy Be Sure You Comprehend the Threat Posed by Disease Before Selecting a Treatment 30

Cancer in Primary Care: Prostate Cancer Screening. How and How often? Should we and in which patients?

Cancer in Primary Care: Prostate Cancer Screening. How and How often? Should we and in which patients? Cancer in Primary Care: Prostate Cancer Screening How and How often? Should we and in which patients? PLCO trial (Prostate, Lung, Colorectal and Ovarian) Results In the screening group, rates of compliance

More information

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj.

PSA Testing 101. Stanley H. Weiss, MD. Professor, UMDNJ-New Jersey Medical School. Director & PI, Essex County Cancer Coalition. weiss@umdnj. PSA Testing 101 Stanley H. Weiss, MD Professor, UMDNJ-New Jersey Medical School Director & PI, Essex County Cancer Coalition weiss@umdnj.edu September 23, 2010 Screening: 3 tests for PCa A good screening

More information

4/8/13. Pre-test Audience Response. Prostate Cancer 2012. Screening and Treatment of Prostate Cancer: The 2013 Perspective

4/8/13. Pre-test Audience Response. Prostate Cancer 2012. Screening and Treatment of Prostate Cancer: The 2013 Perspective Pre-test Audience Response Screening and Treatment of Prostate Cancer: The 2013 Perspective 1. I do not offer routine PSA screening, and the USPSTF D recommendation will not change my practice. 2. In light

More information

Prostate Cancer Screening Recommendations from the US Preventive Services Task Force: Evidence and implementation to optimize health outcomes

Prostate Cancer Screening Recommendations from the US Preventive Services Task Force: Evidence and implementation to optimize health outcomes Prostate Cancer Screening Recommendations from the US Preventive Services Task Force: Evidence and implementation to optimize health outcomes Timothy J. Wilt, MD, MPH, MACP University of Minnesota and

More information

Prostate cancer. Christopher Eden. The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing.

Prostate cancer. Christopher Eden. The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing. Prostate cancer Christopher Eden The Royal Surrey County Hospital, Guildford & The Hampshire Clinic, Old Basing. Screening Screening men for PCa (prostate cancer) using PSA (Prostate Specific Antigen blood

More information

The PSA Controversy: Defining It, Discussing It, and Coping With It

The PSA Controversy: Defining It, Discussing It, and Coping With It The PSA Controversy: Defining It, Discussing It, and Coping With It 11 TH ANNUAL SYMPOSIUM ON MEN S HEALTH June 12, 2013 The PSA Controversy Defining It, Discussing It and Coping With It As of May 2012,

More information

The PLCO Trial Not a comparison of Screening vs no Screening

The PLCO Trial Not a comparison of Screening vs no Screening PSA Screening: Science, Politics and Uncertainty David F. Penson, MD, MPH Hamilton and Howd Chair of Urologic Oncology Professor and Chair, Department of Urologic Surgery Director, Center for Surgical

More information

Early Detection of Prostate Cancer: Sunnybrook Health Sciences Centre Professor of Surgery University of Toronto

Early Detection of Prostate Cancer: Sunnybrook Health Sciences Centre Professor of Surgery University of Toronto Early Detection of Prostate Cancer: How to do it smart Laurence Klotz Sunnybrook Health Sciences Centre Professor of Surgery University of Toronto If screening was a pill: You are a 60 year old male and

More information

Prostate Cancer Screening: What We ve Learned and Where we should go

Prostate Cancer Screening: What We ve Learned and Where we should go Prostate Cancer Screening: What We ve Learned and Where we should go Gerald L. Andriole, MD Robert K. Royce Distinguished Professor Chief of Urologic Surgery Siteman Cancer Center Washington University

More information

Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward

Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward Update on Prostate Cancer: Screening, Diagnosis, and Treatment Making Sense of the Noise and Directions Forward 33 rd Annual Internal Medicine Update December 5, 2015 Ryan C. Hedgepeth, MD, MS Chief of

More information

DECISION AID TOOL PROSTATE CANCER SCREENING WITH PSA TESTING

DECISION AID TOOL PROSTATE CANCER SCREENING WITH PSA TESTING DECISION AID TOOL PROSTATE CANCER SCREENING WITH PSA TESTING This booklet is what is often called a decision aid. The goals of a decision aid are to help people better understand their medical choices

More information

Role of MRI in the Diagnosis of Prostate Cancer, A Proposal

Role of MRI in the Diagnosis of Prostate Cancer, A Proposal Clinical and Experimental Medical Sciences, Vol. 1, 2013, no. 3, 111 116 HIKARI Ltd, www.m-hikari.com Role of MRI in the Diagnosis of Prostate Cancer, A Proposal W. Akhter Research Fellow Urology, Bartshealth

More information

Prostate-Specific Antigen Based Screening: Controversy and Guidelines

Prostate-Specific Antigen Based Screening: Controversy and Guidelines Prostate-Specific Antigen Based Screening: Controversy and Guidelines Eric H. Kim and Gerald L. Andriole Institutional Address: Washington University School of Medicine 4960 Children's Place Campus Box

More information

Screening for Prostate Cancer: Understanding the Evidence, Differences in Screening Guidelines, and Future Directions

Screening for Prostate Cancer: Understanding the Evidence, Differences in Screening Guidelines, and Future Directions Screening for Prostate Cancer: Understanding the Evidence, Differences in Screening Guidelines, and Future Directions American Council of Life Insurers Medical Section Annual Meeting February 24, 2013

More information

Controversites: Screening for Prostate Cancer in Older Adults

Controversites: Screening for Prostate Cancer in Older Adults Controversites: Screening for Prostate Cancer in Older Adults William Dale, MD, PhD University of Chicago Sections of Geriatrics & Palliative Medicine and Hematology/Oncology Director, Specialized Oncology

More information

The Centers for Medicare & Medicaid Services (CMS) seeks stakeholder comments on the following clinical quality measure under development:

The Centers for Medicare & Medicaid Services (CMS) seeks stakeholder comments on the following clinical quality measure under development: The Centers for Medicare & Medicaid Services (CMS) seeks stakeholder comments on the following clinical quality measure under development: Title: Non-Recommended PSA-Based Screening Description: The percentage

More information

PSA screening in asymptomatic men the debate continues www.bpac.org.nz keyword: psa

PSA screening in asymptomatic men the debate continues www.bpac.org.nz keyword: psa PSA screening in asymptomatic men the debate continues www.bpac.org.nz keyword: psa Key messages: PSA is present in the benign and malignant prostate There is currently no national screening programme

More information

Prostate-Specific Antigen (PSA) Based Population Screening for Prostate Cancer: OHTAC Recommendation

Prostate-Specific Antigen (PSA) Based Population Screening for Prostate Cancer: OHTAC Recommendation Prostate-Specific Antigen (PSA) Based Population Screening for Prostate Cancer: OHTAC Recommendation HEALTH QUALITY ONTARIO ONTARIO HEALTH TECHNOLOGY ADVISORY COMMITTEE RECOMMENDATION OHTAC recommends

More information

Prostate Cancer Screening

Prostate Cancer Screening Prostate Cancer Screening Bruce L. Houghton, MD Associate Professor of Medicine Division of General Medicine Department of Internal Medicine Creighton University School of Medicine http://en.wikipedia.org/wiki/image:prostatelead.jpg

More information

Prostate Cancer Screening 18 th February 2016

Prostate Cancer Screening 18 th February 2016 Prostate Cancer Screening 18 th February 2016 Mira Keyes MD FRCPC Clinical Professor Radiation Oncology Department of Surgery UBC Head, BCCA prostate Brachytherapy Program Vancouver Cancer Centre, BC cancer

More information

Prostate cancer screening- pro and contra, lessons from the ERSPC study

Prostate cancer screening- pro and contra, lessons from the ERSPC study Prostate cancer screening- pro and contra, lessons from the ERSPC study Are we ready for a population-based screening program? Dr. Pim J.van Leeuwen Erasmus MC, Rotterdam, The Netherlands On behalf of

More information

Prostate Cancer Screening Guideline

Prostate Cancer Screening Guideline Prostate Cancer Screening Guideline Contents Prevention 2 Screening Recommendations 2 Shared Decision Making 2 Test Recommendations 3 Follow-up/Referral 3 Treatment Overview 4 Evidence Summary 4 References

More information

PSA: Screening for Prostate Cancer in Older Adults

PSA: Screening for Prostate Cancer in Older Adults PSA: Screening for Prostate Cancer in Older Adults William Dale, MD, PhD University of Chicago Sections of Geriatrics & Palliative Medicine and Hematology/Oncology Director, Specialized Oncology Care &

More information

The use of PSA testing in general practice. Ross Lawrenson Waikato Clinical Campus University of Auckland

The use of PSA testing in general practice. Ross Lawrenson Waikato Clinical Campus University of Auckland The use of PSA testing in general practice Ross Lawrenson Waikato Clinical Campus University of Auckland The Team Prostate cancer American Joint Committee on Cancer (AJCC) Staging System The AJCC staging

More information

Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine

Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine Prostate Cancer Screening: Are We There Yet? March 2010 Andrew M.D. Wolf, MD University of Virginia School of Medicine Case #1 A 55 yo white man with well-controlled hypertension presents for his annual

More information

PSA screening: Controversies and Guidelines

PSA screening: Controversies and Guidelines PSA screening: Controversies and Guidelines John Phillips, MD, FACS Department of Urology Urology Center of Westchester New York Medical College Historical PerspecGve Cancer of the prostate, although rare,

More information

Prostate Cancer. Screening and Diagnosis. Screening. Pardeep Kumar Consultant Urological Surgeon

Prostate Cancer. Screening and Diagnosis. Screening. Pardeep Kumar Consultant Urological Surgeon The Royal Marsden Prostate Cancer Screening and Diagnosis Pardeep Kumar Consultant Urological Surgeon Prostate Cancer Screening and Diagnosis 08 02 2013 2 Screening 1 3 Q1.Lots of men have prostate cancer

More information

PSA Screening for Prostate Cancer Information for Care Providers

PSA Screening for Prostate Cancer Information for Care Providers All men should know they are having a PSA test and be informed of the implications prior to testing. This booklet was created to help primary care providers offer men information about the risks and benefits

More information

Guidelines for Cancer Prevention, Early detection & Screening. Prostate Cancer

Guidelines for Cancer Prevention, Early detection & Screening. Prostate Cancer Guidelines for Cancer Prevention, Early detection & Screening Prostate Cancer Intervention Comments & Recommendations For primary prevention, it has been suggested that diets low in meat & other fatty

More information

Modeling Drivers of Cost and Benefit for Policy Development in Cancer

Modeling Drivers of Cost and Benefit for Policy Development in Cancer Modeling Drivers of Cost and Benefit for Policy Development in Cancer Harms? Benefits? Costs? Ruth Etzioni Fred Hutchinson Cancer Research Center Seattle, Washington The USPSTF recommends against routine

More information

TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER

TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER TO SCREEN OR NOT TO SCREEN: THE PROSTATE CANCER DILEMMA Thomas J Stormont MD January 2012 http://www.youtube.com/watch?v=8jd 7bAHVp0A&feature=related related INTRODUCTION A government health panel (the

More information

Prostate Cancer Screening: Phantom menace to society. Folusho Ogunfiditimi, DM, MPH, PA-C Vattikuti Urology Institute Henry Ford Health System

Prostate Cancer Screening: Phantom menace to society. Folusho Ogunfiditimi, DM, MPH, PA-C Vattikuti Urology Institute Henry Ford Health System Prostate Cancer Screening: Phantom menace to society Folusho Ogunfiditimi, DM, MPH, PA-C Vattikuti Urology Institute Henry Ford Health System Objectives USPTF Recommendations on PSA testing Justification

More information

Overuse of PSA Screening for Prostate Cancer in Older Men. Elizabeth Jaramillo, MD January 17, 2014

Overuse of PSA Screening for Prostate Cancer in Older Men. Elizabeth Jaramillo, MD January 17, 2014 Overuse of PSA Screening for Prostate Cancer in Older Men Elizabeth Jaramillo, MD January 17, 2014 Screening Prostate cancer screening occurs in patients with no clinical sign or suspicion of disease Screening

More information

Thomas A. Kollmorgen, M.D. Oregon Urology Institute

Thomas A. Kollmorgen, M.D. Oregon Urology Institute Thomas A. Kollmorgen, M.D. Oregon Urology Institute None 240,000 new diagnosis per year, and an estimated 28,100 deaths (2012) 2 nd leading cause of death from cancer in U.S.A. Approximately 1 in 6 men

More information

Clinical Practice Guidelines

Clinical Practice Guidelines Clinical Practice Guidelines Prostate Cancer Screening CareMore Quality Management CareMore Health System adopts Clinical Practice Guidelines for the purpose of improving health care and reducing unnecessary

More information

Breast cancer screening and prevention: Update from the USPSTF

Breast cancer screening and prevention: Update from the USPSTF Breast cancer screening and prevention: Update from the USPSTF Mark H. Ebell MD, MS Member, USPSTF College of Public Health The University of Georgia What we re going to do today Overview of the USPSTF

More information

A Gene Expression Test to Predict Prostate Cancer Aggressiveness. Use Prolaris as a guide in your medical and surgical management

A Gene Expression Test to Predict Prostate Cancer Aggressiveness. Use Prolaris as a guide in your medical and surgical management A Gene Expression Test to Predict Prostate Cancer Aggressiveness Use Prolaris as a guide in your medical and surgical management What is Prolaris? A direct molecular measure of prostate cancer tumor biology

More information

The 4Kscore blood test for risk of aggressive prostate cancer

The 4Kscore blood test for risk of aggressive prostate cancer The 4Kscore blood test for risk of aggressive prostate cancer Prostate cancer tests When to use the 4Kscore Test? Screening Prior to 1 st biopsy Prior to negative previous biopsy Prognosis in Gleason 6

More information

Science Highlights. To PSA or not to PSA: That is the Question.

Science Highlights. To PSA or not to PSA: That is the Question. Science Highlights June 2012 by Ann A. Kiessling, PhD at the To PSA or not to PSA: That is the Question. The current raucous debate over the commonly used PSA blood test to screen for prostate cancer,

More information

Making sense of prostate cancer screening

Making sense of prostate cancer screening Making sense of prostate cancer screening Piotr Czaykowski MD MSc FRCPC Medical Oncology, CancerCare Manitoba University of Manitoba Disclosure of Potential for Conflict of Interest Name of presenter Name

More information

Prostate Cancer Screening Clinical Practice Guideline. Approved by the National Guideline Directors November, 2013

Prostate Cancer Screening Clinical Practice Guideline. Approved by the National Guideline Directors November, 2013 Prostate Cancer Screening Clinical Practice Guideline This guideline is informational only. It is not intended or designed as a substitute for the reasonable exercise of independent clinical judgment by

More information

NCCN Prostate Cancer Early Detection Guideline

NCCN Prostate Cancer Early Detection Guideline NCCN Prostate Cancer Early Detection Guideline Joan McClure Senior Vice President National Comprehensive Cancer Network African American Prostate Cancer Disparity Summit September 22, 2006 Washington,

More information

Advances in Diagnostic and Molecular Testing in Prostate Cancer

Advances in Diagnostic and Molecular Testing in Prostate Cancer Advances in Diagnostic and Molecular Testing in Prostate Cancer Ashley E. Ross MD PhD Assistant Professor Urology, Oncology, Pathology Johns Hopkins School of Medicine September 24, 2015 1 Disclosures

More information

MEDICAL POLICY SUBJECT: PROSTATE CANCER SCREENING, DETECTION AND MONITORING

MEDICAL POLICY SUBJECT: PROSTATE CANCER SCREENING, DETECTION AND MONITORING MEDICAL POLICY PAGE: 1 OF: 8 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.

More information

PSA Testing for Prostate Cancer An information sheet for men considering a PSA Test

PSA Testing for Prostate Cancer An information sheet for men considering a PSA Test PSA Testing for Prostate Cancer An information sheet for men considering a PSA Test What is the aim of this leaflet? Prostate cancer is a serious condition. The PSA test, which can give an early indication

More information

Cancer Screening. Robert L. Robinson, MD, MS. Ambulatory Conference SIU School of Medicine Department of Internal Medicine.

Cancer Screening. Robert L. Robinson, MD, MS. Ambulatory Conference SIU School of Medicine Department of Internal Medicine. Cancer Screening Robert L. Robinson, MD, MS Ambulatory Conference SIU School of Medicine Department of Internal Medicine March 13, 2003 Why screen for cancer? Early diagnosis often has a favorable prognosis

More information

Prostate cancer. Prevalence and survival in relation to PSA-testing

Prostate cancer. Prevalence and survival in relation to PSA-testing Prostate cancer Prevalence and survival in relation to PSA-testing Jan Adolfsson, MD, PhD Director Oncological Center Karolinska Institute Stockholm, Sweden Radical prostatectomy Retropubic: antegrade

More information

PSA I LOVE YOU: PROSTATE CANCER SCREENING IN IRELAND

PSA I LOVE YOU: PROSTATE CANCER SCREENING IN IRELAND PSA I LOVE YOU: PROSTATE CANCER SCREENING IN IRELAND Eimear Keane Fourth year Medicine, Trinity College Dublin Abstract Ireland has the second highest rate of prostate cancer (PCa) in Europe and this is

More information

Defending PSA Re-Thinking the USPSTF Recommendations for Prostate Cancer Screening Steven Bereta, MS, RN, FNP-C

Defending PSA Re-Thinking the USPSTF Recommendations for Prostate Cancer Screening Steven Bereta, MS, RN, FNP-C Defending PSA Re-Thinking the USPSTF Recommendations for Prostate Cancer Screening Steven Bereta, MS, RN, FNP-C Disclosure I do not have affiliations with any corporate organization that may constitute

More information

Prostate Cancer: Screening Update Middlesex Hospital Cancer Center Comprehensive Prostate Cancer Program

Prostate Cancer: Screening Update Middlesex Hospital Cancer Center Comprehensive Prostate Cancer Program Prostate Cancer: Screening Update Middlesex Hospital Cancer Center Comprehensive Prostate Cancer Program Edward G. Myer, M.D. Middlesex Urology, P.C. October 15, 2015 Middlesex Hospital Cancer Center Comprehensive

More information

Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group

Screening for Cancer in Light of New Guidelines and Controversies. Christopher Celio, MD St. Jude Heritage Medical Group Screening for Cancer in Light of New Guidelines and Controversies Christopher Celio, MD St. Jude Heritage Medical Group Screening Tests The 2 major objectives of a good screening program are: (1) detection

More information

U.S. Preventive Services Task Force

U.S. Preventive Services Task Force U.S. Preventive Services Task Force Screening for Prostate Cancer: Recommendation Statement See related Putting Prevention into Practice on page 283. This summary is one in a series excerpted from the

More information

The Prostate-Specific Antigen (PSA) Test: Questions and Answers

The Prostate-Specific Antigen (PSA) Test: Questions and Answers The Prostate-Specific Antigen (PSA) Test: Questions and Answers Key Points Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. The PSA test measures the level of PSA

More information

Analysis of Prostate Cancer at Easter Connecticut Health Network Using Cancer Registry Data

Analysis of Prostate Cancer at Easter Connecticut Health Network Using Cancer Registry Data The 2014 Cancer Program Annual Public Reporting of Outcomes/Annual Site Analysis Statistical Data from 2013 More than 70 percent of all newly diagnosed cancer patients are treated in the more than 1,500

More information

1. What is the prostate-specific antigen (PSA) test?

1. What is the prostate-specific antigen (PSA) test? 1. What is the prostate-specific antigen (PSA) test? Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. The PSA test measures the level of PSA in the blood. The doctor

More information

Prostate Cancer Early Detection: Update 2010

Prostate Cancer Early Detection: Update 2010 Prostate Cancer Early Detection: Update 2010 Prostate Cancer. Disease Burden The most common non-skin cancer, and the second leading cause of cancer death among U.S. men It is estimated that: 1 in 6 men

More information

Cancer research in the Midland Region the prostate and bowel cancer projects

Cancer research in the Midland Region the prostate and bowel cancer projects Cancer research in the Midland Region the prostate and bowel cancer projects Ross Lawrenson Waikato Clinical School University of Auckland MoH/HRC Cancer Research agenda Lung cancer Palliative care Prostate

More information

Virtual Mentor American Medical Association Journal of Ethics January 2011, Volume 13, Number 1: 10-15.

Virtual Mentor American Medical Association Journal of Ethics January 2011, Volume 13, Number 1: 10-15. Virtual Mentor American Medical Association Journal of Ethics January 2011, Volume 13, Number 1: 10-15. CLINICAL CASE The Debate Over Prostate Cancer Screening Guidelines Commentary by Karen E. Hoffman,

More information

Screening for Prostate Cancer

Screening for Prostate Cancer Screening for Prostate Cancer Review against programme appraisal criteria for the UK National Screening Committee (UK NSC) Version 1: This document summarises the work of ScHARR 1 2 and places it against

More information

Examining the Efficacy of Screening with Prostate- Specific Antigen Testing in Reducing Prostate Cancer Mortality

Examining the Efficacy of Screening with Prostate- Specific Antigen Testing in Reducing Prostate Cancer Mortality St. Catherine University SOPHIA Master of Arts in Nursing Theses Nursing 5-2012 Examining the Efficacy of Screening with Prostate- Specific Antigen Testing in Reducing Prostate Cancer Mortality Rachel

More information

Prostate Cancer PSA Controversy and Emergence of Active Surveillance

Prostate Cancer PSA Controversy and Emergence of Active Surveillance Prostate Cancer PSA Controversy and Emergence of Active Surveillance Christopher J. Kane MD Professor of Surgery, Chief of Urology C Lowell and JoEllen Parsons Chair in Urology Disclosures NCI Kidney Cancer

More information

PROSTATE CANCER UPDATE. Presenter: Bruce W. Porterfield, MD, PhD

PROSTATE CANCER UPDATE. Presenter: Bruce W. Porterfield, MD, PhD PROSTATE CANCER UPDATE DISCLOSURES I, BRUCE WAYNE PORTERFIELD HAVE NOTHING TO DISCLOSE. OBJECTIVES Epidemiology Early detection and screening Review of clinical disease states Treatment options by disease

More information

SIOG Guidelines Update 2014 Prostate Cancer. Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon

SIOG Guidelines Update 2014 Prostate Cancer. Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon SIOG Guidelines Update 2014 Prostate Cancer Dr Helen Boyle Centre Léon Bérard SIOG meeting 25 October 2014,Lisbon Droz JP, Aapro M, Balducci L, Boyle H, Van den Broeck T, Cathcart P, Dickinson L, Efstathiou

More information

Prostate Cancer: Current Evidence Weighs Against Population Screening

Prostate Cancer: Current Evidence Weighs Against Population Screening Prostate Cancer: Current Evidence Weighs Against Population Screening Peter Boyle, PhD, DSc, President, International Prevention Research Institute, Lyon, France, and Otis W. Brawley, MD, Chief Medical

More information

PROSTATE CANCER SCREENING PROSTATE CANCER SCREENING

PROSTATE CANCER SCREENING PROSTATE CANCER SCREENING 3:45 4:45pm Screening Guidelines for Men's Health SPEAKER Radha Rao, MD Presenter Disclosure Information The following relationships exist related to this presentation: Radha Rao, MD: No financial relationships

More information

Prostate cancer screening: clinical applications and challenges

Prostate cancer screening: clinical applications and challenges Urologic Oncology: Seminars and Original Investigations 22 (2004) 353 357 Seminar article Prostate cancer screening: clinical applications and challenges Otis W. Brawley, M.D.* Winship Cancer Institute,

More information

Official reprint from UpToDate www.uptodate.com 2013 UpToDate

Official reprint from UpToDate www.uptodate.com 2013 UpToDate Official reprint from UpToDate www.uptodate.com 2013 UpToDate The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek

More information

Published Ahead of Print on July 16, 2012 as 10.1200/JCO.2012.43.3441. J Clin Oncol 30. 2012 by American Society of Clinical Oncology

Published Ahead of Print on July 16, 2012 as 10.1200/JCO.2012.43.3441. J Clin Oncol 30. 2012 by American Society of Clinical Oncology Published Ahead of Print on July 16, 2012 as 10.1200/JCO.2012.43.3441 The latest version is at http://jco.ascopubs.org/cgi/doi/10.1200/jco.2012.43.3441 JOURNAL OF CLINICAL ONCOLOGY A S C O S P E C I A

More information

Key Messages for Healthcare Providers

Key Messages for Healthcare Providers Cancer Care Ontario: Prostate Cancer Screening with the Prostate- Specific Antigen (PSA) Test Key Messages for Healthcare Providers Considerations for men at average risk Avoid prostate-specific antigen

More information

Update on Prostate Cancer Screening Guidelines

Update on Prostate Cancer Screening Guidelines www.medscape.com Update on Prostate Cancer Screening Guidelines Christine Gonzalez, PharmD, CHHC US Pharmacist Abstract and Introduction Introduction In the United States, prostate cancer is the most common

More information

ERSPC and PLCO Prostate Cancer Screening Studies: What Are the Differences?

ERSPC and PLCO Prostate Cancer Screening Studies: What Are the Differences? EUROPEAN UROLOGY 58 (2010) 46 52 available at www.sciencedirect.com journal homepage: www.europeanurology.com Editorial ERSPC and PLCO Prostate Cancer Screening Studies: What Are the Differences? Fritz

More information

HEALTH NEWS PROSTATE CANCER THE PROSTATE

HEALTH NEWS PROSTATE CANCER THE PROSTATE HEALTH NEWS PROSTATE CANCER THE PROSTATE Prostate comes from the Greek meaning to stand in front of ; this is very different than prostrate which means to lie down flat. The prostate is a walnut-sized

More information

Screening for prostate cancer: the current evidence and guidelines controversy

Screening for prostate cancer: the current evidence and guidelines controversy REVIEW Screening for prostate cancer: the current evidence and guidelines controversy Leonard G. Gomella, MD, 1 Xiaolong S. Liu, MD, 1 Edouard J. Trabulsi, MD, 1 Wm. Kevin Kelly, MD, 2 Ronald Myers, MD,

More information

Prostate Cancer Screening. Dr. J. McCracken, Urologist

Prostate Cancer Screening. Dr. J. McCracken, Urologist Prostate Cancer Screening Dr. J. McCracken, Urologist USPSTF Lifetime risk for diagnosis currently estimated at 15.9% Llifetime risk of dying of prostate cancer is 2.8% Seventy percent of deaths due to

More information

Update on Prostate Cancer Current Controversies Lucas Jacomides, M.D.

Update on Prostate Cancer Current Controversies Lucas Jacomides, M.D. Update on Prostate Cancer Current Controversies Lucas Jacomides, M.D. Assistant Professor of Surgery, Texas A&M Health Science Center College of Medicine Director of Urology, Scott & White-Round Rock The

More information

The 4Kscore blood test for risk of aggressive prostate cancer

The 4Kscore blood test for risk of aggressive prostate cancer The 4Kscore blood test for risk of aggressive prostate cancer Early detection of aggressive prostate cancer Challenges Serum PSA has a high false positive rate Over 1 million prostate biopsies performed

More information

Establishing a Cohort of African-American Men to Validate a Method for using Serial PSA Measures to Detect Aggressive Prostate Cancers

Establishing a Cohort of African-American Men to Validate a Method for using Serial PSA Measures to Detect Aggressive Prostate Cancers Establishing a Cohort of African-American Men to Validate a Method for using Serial PSA Measures to Detect Aggressive Prostate Cancers James R. Hebert, Sc.D., Cancer Prevention and Control Program, University

More information

Prostate Cancer Screening in Taiwan: a must

Prostate Cancer Screening in Taiwan: a must Prostate Cancer Screening in Taiwan: a must 吳 俊 德 基 隆 長 庚 醫 院 台 灣 醫 學 會 105 th What is the PSA test? The blood level of PSA is often elevated in men with prostate cancer, and the PSA test was originally

More information

Early Prostate Cancer: Questions and Answers. Key Points

Early Prostate Cancer: Questions and Answers. Key Points CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Early Prostate Cancer:

More information

Clinical Practice Guidelines and Shared Decision Making for Prostate Cancer Screening

Clinical Practice Guidelines and Shared Decision Making for Prostate Cancer Screening Clinical Practice Guidelines and Shared Decision Making for Prostate Cancer Screening Dr. Roger Luckmann Associate Professor Family Medicine and Community Health UMass Medical School Disclosures I have

More information

Screening for Prostate Cancer

Screening for Prostate Cancer Screening for Prostate Cancer It is now clear that screening for Prostate Cancer discovers the disease at an earlier and more curable stage. It is not yet clear whether this translates into reduced mortality

More information

Linköping University Post Print. Randomised prostate cancer screening trial: 20 year follow-up

Linköping University Post Print. Randomised prostate cancer screening trial: 20 year follow-up Linköping University Post Print Randomised prostate cancer screening trial: 20 year follow-up Gabriel Sandblom, Eberhard Varenhorst, Johan Rosell, Owe Lofman and Per Carlsson N.B.: When citing this work,

More information

Conflict of Interest Disclosures. Outcome of interest. USPSTF Grades. Deepu Gowda, MD, MPH. Screening for the following cancers:

Conflict of Interest Disclosures. Outcome of interest. USPSTF Grades. Deepu Gowda, MD, MPH. Screening for the following cancers: Cancer Screening: Cervical, Colon, Breast, and Prostate Screening Update Conflict of Interest Disclosures Deepu Gowda, MD, MPH Assistant Professor of Clinical Medicine Intensive Review of Internal Medicine

More information

In the absence of data from randomized trials men with

In the absence of data from randomized trials men with 13-Year Outcomes Following Treatment for Clinically Localized Prostate Cancer in a Population Based Cohort Peter C. Albertsen,* James A. Hanley, David F. Penson, George Barrows and Judith Fine From the

More information

Prostate cancer trends in Canada, 1995 to 2012

Prostate cancer trends in Canada, 1995 to 2012 Catalogue no.82-624 X ISSN 1925-6493 Health at a Glance by Lawrence Ellison Release date: April 25, 2016 How to obtain more information For information about this product or the wide range of services

More information

Position Statement on Testing for Prostate Cancer

Position Statement on Testing for Prostate Cancer 1 Position Statement on Testing for Prostate Cancer 2 Key Messages There is still no clear evidence to recommend a national screening programme for prostate cancer. General practitioners (GP s) and other

More information

Breast Cancer Screening Guideline July 1, 2010

Breast Cancer Screening Guideline July 1, 2010 Breast Cancer Screening Guideline July 1, 2010 Introduction These guidelines are informational only and are not intended or designed to substitute the reasonable exercise of independent clinical judgment

More information

In 2014, about 233,000 American men. Prostate Cancer Screening

In 2014, about 233,000 American men. Prostate Cancer Screening ELIE MULHEM, MD, Oakland University William Beaumont School of Medicine, Sterling Heights, Michigan NIKOLAUS FULBRIGHT, MD, Providence Hospital, South Lyon, Michigan NORAH DUNCAN, MD, Oakland University

More information

Evidence for the role of obesity in prostate cancer progression Elizabeth A. Platz, ScD, MPH

Evidence for the role of obesity in prostate cancer progression Elizabeth A. Platz, ScD, MPH Evidence for the role of obesity in prostate cancer progression Elizabeth A. Platz, ScD, MPH Professor and Martin D. Abeloff, MD Scholar in Cancer Prevention Johns Hopkins Bloomberg School of Public Health

More information

PSA Test Provides the Early Prostate Cancer Detection That Has Saved the Life of Thousands of Men

PSA Test Provides the Early Prostate Cancer Detection That Has Saved the Life of Thousands of Men PSA Test Provides the Early Prostate Cancer Detection That Has Saved the Life of Thousands of Men Table of Contents 1. What the research shows on the effectiveness of the PSA test p. 2 2. PSA test guidelines

More information

Prostate cancer screening. It s YOUR decision!

Prostate cancer screening. It s YOUR decision! Prostate cancer screening It s YOUR decision! For many years now, a test has been available to screen for. The test is called the prostate-specific antigen blood test (or PSA test). It is used in combination

More information

PSA: Prostate Cancer Screening

PSA: Prostate Cancer Screening PSA: Prostate Cancer Screening 42 nd Annual Convention of the Philippines College of Physicians May 7, 2012, SMX Convention Center Jose Albert Cruz Reyes III, MD, FPCS, FPUA, DPBU Institute of Urology

More information

Review. Active surveillance: towards a new paradigm in the management of early prostate cancer

Review. Active surveillance: towards a new paradigm in the management of early prostate cancer Prostate cancer surveillance Review Active surveillance: towards a new paradigm in the management of early prostate cancer Chris Parker Prostate cancer is the only human cancer that is curable but which

More information

CJS Debate: Mammography is useful in average risk screening for breast cancer

CJS Debate: Mammography is useful in average risk screening for breast cancer CJS Debate: Mammography is useful in average risk screening for breast cancer 1 Muriel Brackstone MD *, Steven Latosinsky MD* Elizabeth Saettler MD* Ralph George MD From the *London Breast Care Clinic,

More information

Advice to patients about the PSA (prostate-specific antigen) blood test: frequently-asked questions

Advice to patients about the PSA (prostate-specific antigen) blood test: frequently-asked questions Advice to patients about the PSA (prostate-specific antigen) blood test: frequently-asked questions What is the PSA blood test? If you want more information before deciding to have this test, it is important

More information

PROSTATE CANCER. Normal-risk men: No family history of prostate cancer No history of prior screening Not African-American

PROSTATE CANCER. Normal-risk men: No family history of prostate cancer No history of prior screening Not African-American PROSTATE CANCER 1. Guidelines for Screening Risk Factors Normal-risk men: No family history of prostate cancer No history of prior screening Not African-American High-risk men: Family history of prostate

More information

Focus on PSA Screening for Prostate Cancer Vol. 28 Supplement, February 2012. Prostate Cancer: Should We Be Screening?

Focus on PSA Screening for Prostate Cancer Vol. 28 Supplement, February 2012. Prostate Cancer: Should We Be Screening? Focus on PSA Screening for Prostate Cancer Vol. 28 Supplement, February 2012 Prostate Cancer: Should We Be Screening? INSIDE THIS ISSUE 2 Why the Controversy? 3 Active Surveillance 4 The Radical Prostatectomy

More information

Summary of Harms from Screening and Treatment for Prostate Cancer

Summary of Harms from Screening and Treatment for Prostate Cancer DRAFT: Advice from Dr John Childs MoH advisor Summary of Harms from Screening and Treatment for Prostate Cancer There are minimal risks directly attributable to PSA testing or transrectal ultrasound (TRUS)

More information

Dr. Stefaan Van de Perre Dr. An Belmans. Dienst Radiologie. H. Hartziekenhuis Mol A.Z. St.-Dimpna Geel

Dr. Stefaan Van de Perre Dr. An Belmans. Dienst Radiologie. H. Hartziekenhuis Mol A.Z. St.-Dimpna Geel Dr. Stefaan Van de Perre Dr. An Belmans Dienst Radiologie H. Hartziekenhuis Mol A.Z. St.-Dimpna Geel 1 Background Screening trials harms and benefits Practical guidelines Take home messages 2 Background

More information

Screening for Prostate Cancer with Prostate Specific Antigen

Screening for Prostate Cancer with Prostate Specific Antigen Screening for Prostate Cancer with Prostate Specific Antigen January 18, 2013 ERSC Project Lead Investigator: Donna Ciliska ERSC Project Staff: Donna Fitzpatrick-Lewis, Judy Brown, Ali Usman and Maureen

More information