Drastic drop in new prostate cancer diagnoses in US

Following the draft recommendation from the United States Preventive Services Task Force (USPSTF), new diagnoses of prostate cancer in the US declined 28 percent in the very next year, a research says.

"The results raise concern that if this trend continues more men may be diagnosed at a point when their disease is advanced," said first author Daniel Barocas, assistant professor of urological surgery and medicine at Vanderbilt University Medical Centre in the US.

In October 2011, the USPSTF issued a draft guideline discouraging the use of prostate-specific antigen (PSA) based screenings for prostate cancer after concluding the harms outweigh potential benefits. Harmful side effects of treatment may include incontinence, erectile dysfunction and radiation cystitis.

However, the recommendation was considered controversial because of uncertainty about the risk-benefit ratio of screening since prostate cancer is one of the leading causes of cancer death among men in the US, with nearly 30,000 deaths annually and some studies show that screening saves lives.

"Younger healthier men with intermediate or high-risk disease would normally be candidates for aggressive local therapy and they may not be receiving a timely diagnosis under this policy," Barocas said.

To assess the effects of this recommendation, the examiners 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 percent while colon cancer cases remained stable.

The study identified 23.1 percent in high-risk prostate cancer one year after the draft guideline and a drop of 28.1 percent in diagnoses of intermediate-risk disease.

However, the examiners suggested that withholding screening may also result in failure to detect higher-risk cancers during the window of curability.

The results appeared online in The Journal of Urology.