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Understanding the New PSA Test Guidelines

New York, NY, May 6, 2013 -- A new prostate cancer screening decree has been issued, this time from the annual meeting of the American Urological Association (AUA). The new prostate-specific antigen (PSA) test ground rules call for routine screening of men between the ages of 55 and 69 only. The guidelines do allow for earlier or later PSA testing if warranted by risk factors.

David B. Samadi, MD, Chief of Robotics and Minimally Invasive Surgery and Vice Chairman of the Department of Urology at The Mount Sinai Medical Center, was a key presenter at the meeting but not part of the new PSA recommendation. "As we explore how to appropriately implement these guidelines, patient education will be our biggest challenge," advised Dr. Samadi. "Prostate cancer screening must be individualized and PSA screening must be a collaborative decision with a prostate cancer expert."

Making sense of the new PSA test guidelines:

Are you under age 40? The AUA says you should not be screened.

Dr. Samadi says:      

"With blanket recommendations we run the risk of letting younger men fall through the cracks. Men under 40 need to be educated about prostate cancer and given a clear understanding of how risk factors apply to their individual status. This is a critical time in a man's life for establishing a healthy lifestyle that optimizes disease prevention. It's also primetime for baselining a man's PSA level."

Are you age 40-54? The AUA says "no" to routine PSA screening.

Dr. Samadi says:      

"Obesity and excess weight, a family history of prostate cancer, and African American race are the driving risk factors of this disease. It's easy to see that a large majority of American men fall into at least one of these categories, many with overlapping risk. The reality is that early diagnosis and treatment can prevent prostate cancer metastasis."

Are you age 55-69? The AUA says you should consider the pros & cons of screening and treatment before having a PSA test.

Dr. Samadi says:      

"Risk of prostate cancer increases significantly by age 65. Certainly it is wise for men in this age bracket to be screened. These men have the greatest opportunity for early detection and treatment to eliminate their prostate cancer with optimal quality of life."

PSA test every year? The AUA says every 2 years is sufficient, not annually.

Dr. Samadi says:      

"The goal of this guideline is to reduce false positives and hyper-vigilance, namely because the PSA test is not a prostate cancer test. PSA results are valuable when collected over a period of years for trend monitoring. It is a spike in PSA level--not one test--that signals the potential presence of prostate cancer. The earlier monitoring starts, the better."

Are you over age 70? The AUA says no need screen unless you plan to live to 80.

Dr. Samadi says:

"A large percentage of Americans live well into their 80s and beyond. Prostate cancer screening should be part of overall wellness monitoring for these men. Thorough education about prostate cancer testing, diagnosis, and treatment can help each man decide what's best for them."
David B. Samadi, MD

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 “On post-op day 10, my father went to the US Tennis Open by himself and on day 12, he took a transatlantic flight home to Romania. One and two months after surgery, his PSA was 0..”

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