MONTREAL, Nov. 3, 2014 /CNW Telbec/ - Prostate cancer remains the most common cancer and the third most common cause of cancer-related deaths in Canadian men. The Canadian Urological Association (CUA) disagrees with the recent recommendations by the CTFPHC on prostate cancer screening.
CTFPHC recommendations below, apply to all men without a previous diagnosis of prostate cancer:
- For men aged less than 55 years, they recommend not screening for prostate cancer with the PSA test (strong recommendation; low-quality evidence).
- For men aged 55–69 years, they recommend not screening for prostate cancer with the PSA test (weak recommendation; moderate-quality evidence).
- For men 70 years or older, they recommend not screening for prostate cancer with the PSA test (strong recommendation; low-quality evidence).
CUA recognizes that prostate cancer screening is a controversial topic. Contentious medical topics may not lend themselves to guideline development. Based on the current evidence, many clinicians in the prostate cancer field anticipated a more positive recommendation given that (1) level 1evidence of a reduction in prostate cancer deaths was demonstrated in randomized Phase III trials, (2) 45% reduction in deaths due to prostate cancer in Canada since 1995, and (3) the widespread adoption of active surveillance for low-risk disease in Canada minimizes the risks of overtreatment.
CUA does not support the CTFPHC recommendation. CUA continues to support selective PSA screening; CUA recommends a shared decision making process where healthy men with a good life expectancy should have the choice to be tested and not be dissuaded from doing so. A more detailed update of our prostate cancer screening guidelines is expected to be released in 2015.
In the absence of broadly accessible alternatives to the PSA test for prostate cancer screening, dismissing PSA testing would achieve a great disservice to Canadian men. PSA screening has been shown to decrease metastatic disease and prostate cancer-related deaths and save lives.
It is reassuring that not only most of the urologic and cancer societies are in favor of PSA screening but this opinion is also shared by provincial bodies such as the Collège des Médecins du Québec who has recently re-evaluated the evidence and published their recommendation in favor of a shared decision making process towards PSA screening (www.cmq.org).
For a complete critical analysis drafted by an expert panel of CUA members in response to the CTFPHC recommendation of PSA screening, please refer to www.cua.org.
Wassim Kassouf, MD
Vice President Communications
Canadian Urological Association
SOURCE: CANADIAN UROLOGICAL ASSOCIATION
For further information: CUA, C/O Nadia P. Pace, Director of Communications, 185 Dorval, #401, Dorval, QC - H9S 5J9, C: (514) 212-9313, T: (514) 395-0376 ext.24, F: (514) 395-1664, [email protected]