AMERICAN UROLOGICAL ASSOCIATION (AUA) ISSUES NEW PROSTATE SCREENING GUIDELINES (APR 2013) - The AUA issued new prostate screening guidelines in APR 2013. The Prostate Specific Antigen (PSA) blood test is the primary method used to screen for prostate cancer. In the past, annual PSA testing and Digital Rectal Exam (DRE) starting at the age of 50 was recommended for all men. Recent studies have called into the question the benefit of this blanketed screening approach. In May 2012, the USPSTF recommended against routine PSA screening (see USPSTF PSA recs). The new AUA guidelines are more in line with this view.



StraightHealthcare analysis: The AUA guidelines are now more in line with the USPSTF guidelines. They make soft recommendations for screening certain high-risk groups, but they do not assert that any group of men should be screened routinely. This is significant given that prostate biopsies after abnormal PSAs are significant source of business for many urologists. Interestingly, The AUA guidelines do not mention Agent Orange exposure which has been associated with an increased risk of prostate cancer. Also of note, benign prostatic hypertrophy (BPH), a common reason for drawing a PSA, is not a proven risk factor for prostate cancer.

PSA screening is likely prudent in men who have a very strong family history of prostate cancer. It's unclear if it is beneficial in African-Americans without a family history of prostate cancer. Routine screening of all men has no proven benefit.