Drop in screenings drop in diagnoses.

• Position: Prostate Cancer

In October 2011, the U.S. Preventive Services Task Force Issued a draft guideline discouraging the use of prostate-specific antigen-based screenings for prostate cancer after concluding the harms outweigh potential benefits. Harmful side effects of PSA treatment may include Incontinence, erectile dysfunction, and radiation cystitis.

However, the "grade D" recommendation was considered controversial because of uncertainty about the risk-benefit ratio of screening since prostate cancer Is the second-leading cause of cancer death among men In the U.S., with nearly 30,000 deaths annually, and some studies show that screening saves lives.

To assess the effects of this recommendation, investigators from Vanderbilt University Medical Center, Nashville, Tenn., identified new cancers diagnosed between January 2010 and December 2012 in the National Cancer Database. They studied the trend of prostate cancers diagnosed each month before and after the draft guideline, compared with new colon cancer cases.

The research revealed that, 12 months after the draft USPSTF guidelines were published, diagnoses of new low-risk cancers had fallen by 37.9% while colon cancer cases remained stable.

New prostate cancer diagnoses also declined by 23% to 29.3% among men over age 70 and 26% among men considered infirm. The authors note these are populations unlikely to live long enough to benefit from early detection and are at risk of harms of treatment.

However, the Investigators suggest that withholding screening also may result in failure to detect higher-risk cancers during the window of curability. Timely treatment of Intermediate- and high-risk localized disease Is associated with superior overall survival...