Burning Bridges? - New Guidelines on PSA testing

[Paul Edwards]

On 16 January 2016 The "PSA Testing and Early Management of Test-detected Prostate Cancer: Guidelines for health professionals", were approved by the National Health and Medical Research Council (NHMRC).   The Guidelines say that men wanting to undergo prostate cancer testing should be told the harms may outweigh the benefits.

 

Click on this link to read the guidelines.

 

 

In 2012 the United States Preventative Services Task Force made a recommendation is against PSA based screening for healthy men, asserting that there is “moderate or high certainty that the service has no benefit or that the harms outweigh the benefits”.

 

Recent studies published in the Journal of the American Medical Association showed that PSA tests for prostate cancer as well as the incidence of early-stage prostate cancer have declined substantially since the United States Preventive Services Task Force recommendation.  However, since the recommendation, more patients are presenting with advanced prostate cancer.

 

Will the consequences in Australia of the NHMRC Guidelines be the same as the US experience after the Preventive Services Task Force recommendation?   Will a decline in PSA testing in Australia mean a missed opportunity to uncover and successfully treat those cancers destined to cause harm before they become advanced?

 

An earlier Statement on PSA Testing “The 2013 Melbourne Consensus Statement” said:

 

“treatment or non-treatment decisions can be made once a cancer is found, but not knowing about it in the first place surely burns bridges”.

 

The 2013 Melbourne Consensus Statement took the view that “Prostate cancer diagnosis must be uncoupled from prostate cancer intervention.”   The NHMRC Guidelines fail to uncouple diagnosis from intervention and are, in my opinion, flawed.

[Geoff Buttfield]

I can only surmise that the (somewhat self appointed) foundation that is purporting to represent all men (past, present & future) affected by PCa in Australia has somewhat dropped the ball by supporting this. 

The voice of younger men (<60) was certainly not included in the formulation of these guidelines, and were certainly not represented by the consumer representatives.

This is from the PCFA website-LAST YEAR

http://www.prostate.org.au/research/research-news/relaxed-guidelines-on-psa-testing-might-miss-aggressive-tumors-study/

[Paul Edwards]

In an article in the Australian Financial Review of 23 February 2016 Professor Allan Spigelman, the Director of Cancer Genetics, St Vincent's Hospital, Sydney points out what he considers is a significant omission in the Guidelines.