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Prostate Cancer Screening Not Recommended Over Age 75

Benefits of screening unclear even in younger men

TUESDAY, Aug. 5 (HealthDay News) -- Men older than 75 years of age should not be screened for prostate cancer, and the benefits of screening are uncertain even in younger men, according to updated clinical guidelines published in the Aug. 5 issue of the Annals of Internal Medicine.

Ned Calonge, M.D., from the Colorado Department of Public Health and Environment in Denver, and colleagues from the U.S. Preventive Services Task Force (USPSTF) evaluated clinical trials and other data regarding screening for prostate cancer available since 2002, when the most recent guidelines on prostate cancer screening were issued.

Most prostate cancers will never cause symptoms during the patients' lifetime, according to the researchers. The previous review had found no evidence that screening improved health outcomes such as mortality, although it also found no clear harm. The accuracy of screening based on prostate-specific antigen (PSA) levels is difficult to assess due to the inaccuracy of needle biopsies, while longitudinal studies have shown that the sensitivity of PSA screening is higher for aggressive cancers. Randomized controlled trials continue to suggest that early detection and treatment of prostate cancer does not improve mortality, the authors found.

"The USPSTF concludes that for men younger than age 75 years, the benefits of screening for prostate cancer are uncertain and the balance of benefits and harms cannot be determined," the authors write. "For men 75 years or older, there is moderate certainty that the harms of screening for prostate cancer outweigh the benefits."

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