UPDATE - Issue 40 - Spring 2010
US prostate cancer screening guidelines make important distinction for informed choice
Newly updated prostate cancer screening guidelines from the American Cancer Society reaffirm the recommendation that men should discuss the uncertainties, risks and potential benefits of screening for prostate cancer before deciding whether to be tested. The update is the first since 2001 and was done as part of the Society's regular guidelines update process.
Like the UK guidelines, the emphasis is on informed choice for the patient and making sure they are equipped with the appropriate information to make that choice. However, there is a difference in that 'Men at average risk should receive this information beginning at age 50. Men at higher risk... at age 45. Men at appreciably higher risk... should receive this information beginning at age 40.'
The distinction here is clearly to make men aware that they should consider their options. From this point 'asymptomatic men who have at least a ten-year life expectancy should have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after receiving information about the uncertainties, risks, and potential benefits associated with screening.'
This is a much more pro-active approach to ensuring informed choice than the UK model of waiting for the patient to find out of their own accord. We are concerned that men are not aware of the need to make a choice in the first place. A full PSA screening programme may not be the answer but we believe a formally organised awareness strategy for those men in higher risk categories would be of benefit and would save lives. Prostate UK is working with clinicians, other charities and the Department of Health to drive this forward.