The American Urological Association’s complete new statement on the use of PSA is now available on the AUA web site. New consumer- and patient-directed information about PSA testing is now available on the web site of the AUA Foundation.
Readers should note that this “best practice statement” and the supporting consumer and patient brochure are not limited to the use of PSA in initial testing and diagnosis, but encompass the use of PSA in three settings:
- Early detection of prostate cancer
- Pretreatment staging of prostate cancer
- Post-treatment management of prostate cancer
The “New” Prostate Cancer InfoLink will be studying the new statement with care to see how closely this corresponds with our own perceptions of how PSA data are best applied today, particularly in the first two of the above settings, since these are areas of considerable controversy.
Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk, Treatment, Uncategorized | Tagged: best practice, guidelines, PSA |
THE "NEW" PROSTATE CANCER INFOLINK 
Regarding the first part “Early detection of prostate cancer,” do you think H. Ballentine Carter, MD (I see now, that’s Bal Carter) who was on the panel had a major part to play?
They have adopted the main parts from his audio interview. (I’m not sure when it was recorded.)
Mike,you must welcome this part of the best practice statement?
Secondly, the current policy no longer recommends a single, threshold value of PSA which should prompt prostate biopsy.
Rather, the decision to proceed to prostate biopsy should be based primarily on PSA and 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. In addition, although recently published trials show different results with regard to the impact of prostate cancer screening on mortality, both suggest that prostate cancer screening leads to over-detection and over-treatment of some patients.
Therefore, the AUA strongly supports that men be informed of the risks and benefits of prostate cancer screening before biopsy and the option of active surveillance in lieu of immediate treatment for certain men newly diagnosed with prostate cancer.
Dear 5th String:
As stated above … I want to read the physician guidelines with care before I comment further. As always, the devil is in the details.