einstein (São Paulo). 01/Jul/2017;15(3):7-10.

New US Preventive Service Task Force recommendations for prostate cancer screening: a needed update, but not enough

Marcelo Langer Wroclawski

DOI: 10.1590/S1679-45082017ED4151

Prostate cancer (PC) screening remains a controversial topic, although it has been studied for more than two decades. Since the 1990s, when the use of Prostate-Specific Antigen (PSA) began in clinical practice, the mortality rate from PC has decreased by around 50%. Prostate cancer screening policies, early diagnosis and treatment are pointed out as responsible to 45%-70% of this reduction.() On the other hand, indiscriminate screening can lead to problems because of unnecessary prostate biopsies, and their possible side effects, such as infection and bleeding, and overdiagnosis and overtreatment of PC. These clinically non-significant tumors may be diagnosed and treated, perhaps, without any benefit to the patient. In addition, treatment sometimes causes potential side effects, such as urinary incontinence and erectile dysfunction –consequently worsening the quality of life.

The controversy became even greater when in 2012 the US Preventive Services Task Force (USPSTF) discouraged the use of PSA as a tool for PC screening (grade D recommendation), regardless of patient’s age.()

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New US Preventive Service Task Force recommendations for prostate cancer screening: a needed update, but not enough

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