As primary care physicians, a large part of our role is to prevent or detect cancers early. Patients look to us for this guidance.
However, prostate cancer screening has long been a controversial issue. Earlier this year, the American Urological Association along with the Society of Urologic Oncology publishedClear recommendations that come from this set of guidelines that are relevant to primary care physicians include:repeating PSA in patients with newly elevated results before moving on to other test.offering baseline screening in those between 45-50 years of age.
The guidelines make recommendations regarding PSA screening and biopsy standards. These guidelines are very specific in their recommendations; however, the question about whether to do PSA screening in the first place is left open to debate. While shared decision-making is important with any testing, it is more difficult with prostate cancer screening.
More research into biomarkers to detect prostate cancer is needed, as suggested by the guideline authors. As primary care doctors, we’re the first ones to order these tests and make decisions regarding the results. While we may not be the ones to do the biopsies, we do need to know when to refer the patients to specialists or when we can just repeat the test.
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