Prostate Cancer Screening Overused in Older Men

A 2024 study published in JAMA Network Open reveals that many men aged 70 and older, as well as those with limited life expectancy, continue to undergo prostate cancer screening despite clear guidelines advising against it. The US Preventive Services Task Force (USPSTF) recommends PSA-based screening only for men aged 55–69 through individual decision-making and advises against it for men over 70 due to low potential benefits and higher risks, such as overdiagnosis and complications from unnecessary biopsies. Researchers analyzed data from 57,397 men aged 60 and older and found that a significant number of older men, even those with high 10-year mortality risk, still received screenings. This persistent overuse is likely due to confusion from changing guidelines, clinician caution, and difficulty in discussing life expectancy with patients. Clinicians may continue screening out of habit or concern about missing a diagnosis, despite limited benefits. The findings underscore the need for better tools to support shared decision-making between doctors and patients, aiming to ensure that only those who are likely to benefit undergo screening. Improving these conversations may help align clinical practice with current evidence-based guidelines and avoid unnecessary harm to older patients.

Melville, N. A. (2024, May 15). Outside the guidelines: Prostate cancer screening overused in older men. MDedge Hematology and Oncology. https://www.mdedge.com/hematology-oncology/article/269198/preventive-care/outside-guidelines-prostate-cancer-screening/page/0/1