Bucking Landmark U.S. Recommendation, Oncologist Urges PSA Screening

Despite a United States Preventive Services Task Force (USPSTF) 2012 conclusion that routine tests for prostate cancer are unnecessary, a prominent oncologist believes such screenings should be encouraged.

Vladimir Ioffe, MD, a radiation oncologist with 21st Century Oncology, said prostate-specific antigen (PSA) screenings ought to be recommended for African-American males, men with a family history of the disorder, and healthy males ages 70–80.

Discontinuing such tests could result in more than 6,000 prostate cancer-related deaths annually in the United States, he said. Ioffe’s study was completed in collaboration with Navin Shah, MD; Thomas Huebner, MD, and Ivelina Hristova, BA.

”Our study shows that the current USPSTF prostate cancer screening recommendations are harmful and result in later-stage prostate cancer detection,” Ioffe said in a press release. “We are seeing more late-stage diagnoses with more aggressive prostate cancer and in non-curable stages. We strongly believe that PSA-based prostate cancer screening should be cleared, recommended, and endorsed, especially for high-risk men.”

He said that since the task force’s announcement, there has been a 9% rise in diagnoses of aggressive disease. This suggests that a lack of screening prevented earlier cancer detection. In addition, Ioffe found that while the number of biopsies for prostate cancer had dropped by 30 percent, the cancer detection rate doubled.

In particular, black men in the United States have roughly a 15 percent chance of developing prostate cancer during their lifetime — 5 percent more than white men — and are more likely to have a more aggressive form than other racial and ethnic groups.

In its recommendation statement, the task force said: “Although the precise, long-term effect of PSA screening on prostate cancer-specific mortality remains uncertain, existing studies adequately demonstrate that the reduction in prostate cancer mortality after 10-14 years is, at most, very small, even for men in what seems to be the optimal age range of 55 to 69 years. There is no apparent reduction in all-cause mortality.”

The USPSTF is an independent volunteer panel of national experts in disease prevention and evidence-based medicine. It works to improve the health of U.S. residents by making evidence-based recommendations about clinical preventive services.

Headquartered in Fort Myers, Florida, 21st Century Oncology is a leading provider of integrated cancer care services in 16 states and seven Latin American countries.