Implications of the new USPSTF prostate cancer screening recommendation—attaining equipoise
Ce dossier présente la mise à jour des recommandations 2012 de l'"US Preventive Services Task Force" concernant le dépistage du cancer de la prostate par dosage sérique de l'antigène prostatique spécifique
In abandoning its 2012 objection to prostate-specific antigen (PSA)–based screening for prostate cancer (D recommendation),1 the US Preventive Services Task Force (USPSTF) now supports individualized decision making for men aged 55 to 69 years (C recommendation).2 The new Task Force recommendation, supported by an evidence report and systematic review,3 now aligns the USPSTF with the American Cancer Society4 and the American Urological Association.5 The USPSTF recommendations, which have consistently been evidence based, appear to have a large influence on practice patterns. Following the 2008 recommendation against screening men older than 75 years,6 prostate cancer screening and cancer incidence rates markedly declined for older men.7 In the year following the 2011 release of a draft recommendation against any screening (D recommendation; final version published in May 20121), the number of men diagnosed with prostate cancer decreased by over 33 000.7 Prostate cancer screening rates also subsequently decreased among all age groups by 2013.7 The new C recommendation2 may well be associated with a resurgence in prostate cancer screening and increased numbers of prostate cancer cases diagnosed, especially if the new guidelines are misunderstood to be endorsing screening rather than offering a more nuanced message about decision making.
JAMA Internal Medicine , éditorial en libre accès, 2017