AUA clarifies recommendations on early prostate cancer testing

Despite recent news reports disparaging prostate cancer testing, early detection of the disease remains in the best interest of the patient, according to an AUA statement clarifying its testing recommendations.

In the statement, AUA recommends that men ages 40 years and older be offered a baseline PSA test and digital rectal exam for early detection and risk assessment. As future risk of prostate cancer is closely related to a man’s PSA score, men who are screened at an early age can be tracked over time, AUA argues.

AUA also strongly urges an informed consent process that includes a discussion about the benefits and risks of testing.

"The controversy over prostate cancer should not surround the test, but rather how test results influence the decision to treat," said AUA Past President John Barry, MD. "The decision to proceed to prostate biopsy should be based not only on elevated PSA and/or abnormal DRE results, but should take into account multiple factors including free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity, prior biopsy history, and comorbidities.

"A cancer cannot be treated if it is not detected. Not all prostate cancers require immediate treatment; active surveillance, in lieu of immediate treatment, is an option that should be considered for some men. Testing empowers patients and their urologists with the information to make an informed decision."