Missing the Mark on Prostate-Specific Antigen Screening
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 US Preventive Services Task Force recently issued a draft recommendation against prostate-specific antigen (PSA) screening for prostate cancer. After performing a rigorous review of the relevant empirical literature, the task force concluded with “moderate certainty” that the harms of PSA-based detection (eg, biopsy-related complications) and early intervention (eg, incontinence, erectile dysfunction) exceed the potential benefits. For this reason, the task force now proposes discouraging PSA screening among men who are free of symptoms suspicious for prostate cancer.
Most clinicians are aware that PSA is an imperfect tool for the early detection of prostate cancer. First, rather than being focused on patients most likely to benefit from early detection, the use of PSA as a screening test is often undiscerning.2 Second, PSA-based screening can be inconclusive. As a consequence, for some patients this process can lead to a cycle of repeated venipuncture and biopsy, as well as psychological …
JAMA: The Journal of the American Medical Association , commentaire, 2011