On May 3, 2013, the American Urological Association (AUA) released a new Clinical Guideline on the Early Detection of Prostate Cancer. The new guideline, which addresses screening in asymptomatic men of average risk of prostate cancer, updates the Association's Best Practice Statement on Prostate-Specific Antigen (PSA), originally released in 2009.
The following tools are available to help the health care community and the public better understand and implement the guideline:
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The following videos are also available
About the Early Detection of Prostate Cancer Guideline
Development of the new guideline began in 2011, and the document was peer reviewed by more than 50 AUA members prior to being approved by the AUA's Board of Directors. While much of the media coverage concerning the guidelines has been accurate, some outlets have mistakenly stated that the AUA has changed its position and is now recommending against prostate cancer screening in all men at risk for this common disease. In fact, this is not at all what the guidelines state. Compared to the 2009 best practice policy document, the guidelines do narrow the age range in which informed decision making around PSA screening should be offered to men at average risk for prostate cancer, but they do not make a blanket statement against screening, as some have implied. Importantly, the guidelines only apply to men at average risk. The guidelines do not apply to symptomatic men or those at high risk for disease (men with a family history or of African-American race), who are encouraged to discuss their individual case with their doctor, regardless of their age. Additionally, it should be noted that the AUA remains in disagreement with the U.S. Preventive Services Task Force in recommendation against prostate cancer screening in all men, regardless of age or risk, without even considering a discussion of the risks and benefits of screening. The AUA continues to support a man's right to be tested for prostate cancer -- and to have his insurance pay for it, if medically necessary.
Clinical guidelines utilize the best evidence from a systematic literature review and a rating of the evidence and interpretation of the evidence based on randomized controlled trials with modeled and population data as supporting evidence. Unlike other clinical guidance documents (e.g., best practice statements or white papers), guidelines do not make statements that go beyond the available evidence (assumption of benefits in the absence of evidence). The AUA recognizes that additional research is necessary on the topic of early prostate cancer detection, and that ongoing research could lead to changes in the guideline statements. The AUA plans to update the guideline on a regular basis to accommodate new developments.
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