American Urological Association (AUA) response to US Preventative Services Task Force recommendations on PSA screening

USPSTF Issues Draft Recommendations on PSA Screening

On October 7, 2011, the U.S. Preventive Services Task Force (USPSTF) released new draft recommendations against prostate-specific antigen (PSA)-based screening for prostate cancer, asserting that there is "moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," and discouraged the use of the test by issuing it a Grade D rating.

The AUA's Position

The AUA strongly opposes this position, and feels that the Task Force is doing men a great disservice by disparaging what is now the only widely available test for prostate cancer, a potentially devastating disease. We hold true to our current position as supported by the AUA's Prostate-Specific Antigen Best Practice Statement that, when interpreted appropriately, the PSA test provides important information in the diagnosis, pre-treatment staging or risk assessment and monitoring of prostate cancer patients. But not all prostate cancers are life threatening. The decision to proceed to active treatment or use surveillance for a patient's prostate cancer is one that men should discuss in detail with their urologists.

The AUA's Response

Immediately following the release of the USPSTF recommendations, AUA President Sushil S. Lacy, MD, released a formal statement on behalf of the AUA. The AUA is also coordinating a sign-on letter for lawmakers to send collectively to U.S. Health and Human Services Secretary Kathleen Sebelius, urging her to reject the USPSTF recommendations. We are currently in the process of convening an expert Panel, which will prepare and submit formal comments to the USPSTF.

How You Can Get Involved

The specialty of urology is not represented in the USPSTF, as there is no urologist on the Task Force. As the specialists who diagnose and treat the majority of prostate cancers in the United States, we must make our opinions known. Here's how you can get involved:

• Submit comments to the USPSTF: Lend your individual voice to this debate. Take time to review the USPSTF draft recommendations and submit your own comments.
• Contact the media: The AUA has prepared a sample letter to the editor and talking points for you to use in crafting letters to submit to your local newspapers. Sending these letters is helpful not only in elevating public discussion on this issue, but also letting your patients know your stance on the recommendations.
• Contact your lawmaker: Help Members of Congress understand how the new USPSTF recommendations affect patients. Sample letters are available at the AUA Advocacy Center.
• Tell your patients: The AUA Foundation has prepared a one-page information sheet about prostate cancer testing. We encourage you to share this resource with your patients.

In the News 

News outlets around the country are reporting on this issue. Below are some highlights of these top stories:

• "Prostate Test Recommendation Draws Mixed Reviews," MedPage Today
• "Panel's Advice on Prostate Test Sets Up Battle," The New York Times
• "Report Resets Prostate Testing Debate," The Wall Street Journal
• "Should I get screened for that?," CNN