Prostate Cancer Screening—Time to Abandon One-Size-Fits-All Approach?
Ces articles offrent divers points de vue sur le projet de recommandations, rédigées par un groupe d'experts américains, en matière de dépistage du cancer de la prostate
The new US Preventive Services Task Force draft recommendations discourage use of prostate-specific antigen (PSA) screening among asymptomatic men, regardless of age, race, or family medical history. This one-size-fits-all recommendation derives from the overdiagnosis and overtreatment of many patients with PSA-screened asymptomatic prostate cancer; it cites a “statistically insignificant 0.06% absolute reduction in prostate cancer–specific deaths for men aged 50 to 74 years”1 after a median of 9 years in the European Randomized Study of Screening for Prostate Cancer. But is the current evidence sufficient to discourage PSA screening in asymptomatic men and ultimately remove PSA screening from optional testing if Medicare or third-party payers adopt the task force's recommendation?
Overdiagnosing and overtreating prostate cancer are major concerns. However, eliminating PSA-based screening is premature in the face of the lengthy natural history of the disease, consequences of shifts in the aging population, and the complexity of prostate …
JAMA: The Journal of the American Medical Association , commentaire, 2011