AUA:Prostate-Specific Antigen Best Practice Statement:2009 Update

The American Urological Association (AUA) goals are for the advancement of urological clinical care through education,research and in the formulation of health care policy,which although directed towards the US will obviously be taken on board by individual countries in full/part or as an informative aid in setting up their own health care policies.

Prostate-Specific Antigen Best Practice Statement:2009 Update AUA-27th April 2009

Prostate-Specific Antigen (PSA) Best Practice Policy:2000" AUA-February 2000


My view and MY VIEW ONLY:

First and foremost it's up to the individual whether he gets tested or not!

The AUA 2009 Update for the initial testing for possible PC is a much needed revision from the 2000 version especially in the reduction of unnecessary biopsies.

2000 version:

6. When is a prostate biopsy indicated?

Although an abnormal DRE or an elevated PSA may suggest the presence of prostate cancer, cancer can only be confirmed by the pathologic examination of prostate tissue. A urologist should be consulted for a prostate biopsy when any of the following findings are present:

1 PSA is 4.0 ng/mL or more;
2 A significant PSA rise from one test to the next; or
3 DRE is abnormal.

2009 Update (My interpretation):

PSA test to be made available (USA) to men 40 years and older who may or may not show signs of possible PC but have a family history of PC or/and after being informed of the +/-'s attributed to the two initial tests (DRE and PSA) they decide to get tested.

Relating to the flow chart on page 9 of the 2009 Update and after a DRE/PSA test:

1. DRE abnormal/PSA low
for age (consider possible
causes: prostate cancer, BPH,
infection, trauma, etc)
2. PSA high for age or
3. DRE abnormal and PSA
high

THEN

Counsel patient regarding both
risks and benefits of biopsy

CHOICE

Biopsy done,extended, local anesthesia OR Biopsy not done AND then Return regularly for PSA and DRE

Will add to another day








Below are some articles relating to the AUA statement:


Testing for prostate cancer 10 years earlier Macleans-5th May


THE "NEW" PROSTATE CANCER INFOLINKThe new AUA guidance on PSA testing:a critical analysisThe “New” Prostate Cancer InfoLink-2nd May

AUA:Urologists Support Baseline PSA Test at Age 40 MedPage Today-29th April



AUA recommends individualised PSA testing for men aged 40 or olderUrosource-28th April


AUA counters mainstream recommendations with new best practice statement on PSA testingBio-Medicine-27th April