This is the current release of the guideline.

This summary updates a previous version: Ferrini R, Woolf SH. American College of Preventive Medicine Practice Policy: screening for prostate cancer in American men. Am J Prev Med 1998 Jul;15(1):81-4.

The American College of Preventive Medicine (ACPM) concludes that there is currently insufficient evidence to recommend routine population screening with digital rectal examination (DRE) or prostate-specific antigen (PSA), concurring with the Unites States Preventive Services Task Force (USPSTF) recommendation. The College is in agreement with the American College of Physicians (ACP) that men should be given information about the potential benefits and harms of screening and limits of current evidence in order to make an informed decision about screening. Discussion about screening should occur annually, during the routine periodic examination, or in response to a request by the patient. The effectiveness of prostate cancer screening is questionable in elderly men with competing co-morbidities and men with life expectancies of less than 10 years. Ultimately, a man should be allowed to make his own choice about screening, in consultation with his physician, taking into consideration personal preferences and life expectancy. If the patient prefers to defer to the clinician or is unable to make a decision regarding screening, then testing should not be offered as long as the patient understands the benefits, potential limitations, and adverse effects associated with screening. Key points that should be communicated during the patient encounter regarding prostate cancer screening are listed in the table below.

Pending resolution of ongoing controversies, screening for prostate cancer among African-American men and those with a family history of prostate cancer has the potential to detect treatable forms of disease that are more likely to occur in these groups than in the general population. While the usual age for prostate cancer screening is between 50 to 70 years in average risk men, it has been suggested that those who are at high risk may benefit from earlier screening beginning at age 45, while higher-risk men (those with two or more first-degree relatives with prostate cancer before age 65) be screened at age 40. Granted that prostate cancer is more likely to be found in high-risk men, issues pertaining to tumor grade have yet to be resolved (that is, optimal grade of tumor that a screening test should detect to confer a benefit in survival or morbidity), and there is still no evidence establishing effectiveness of screening in high-risk men. In the meantime, further studies are needed to establish the efficacy and optimal age at which prostate cancer screening should be initiated in these high-risk population groups.

None provided

The type of evidence supporting the recommendations is not specifically stated.

In general, the recommendations are based on a review of the literature prior to July 2007 and recommendations from other groups.

Not applicable: The guideline was not adapted from another source.

1998 (revised 2008 Feb)

American College of Preventive Medicine - Medical Specialty Society

American College of Preventive Medicine

ACPM Prevention Practice Committee

Authors: Lionel S. Lim, MD, MPH, FACP; Kevin Sherin, MD, MPH, FACPM

Committee Members: Gershon H. Bergeisen, MD, MPH; Michael T. Compton, MD, MPH; V. James Guillory, DO, MPH, FACPM (Chair); Doug I. Hammer, MD, MPH, DrPH; Joylene John-Sowah, MD, MPH; Steven Jonas, MD, MPH (Consultant); Elizabeth Kann, MD, MPH; Ronit B. Katz, MD, FACPM; Robin McFee, DO, MPH, FACPM; Elaine S. Perry, MD, MS; Jennifer E. Rogers, MPH (Staff); and Michele A. Surricchio, MPH, CHES (Staff)

No financial disclosures were reported by the authors of this paper.

This is the current release of the guideline.

This summary updates a previous version: Ferrini R, Woolf SH. American College of Preventive Medicine Practice Policy: screening for prostate cancer in American men. Am J Prev Med 1998 Jul;15(1):81-4.

None available

None available

This summary was completed by ECRI on September 1, 1998. The information was verified by the guideline developer on December 1, 1998. This NGC summary was updated by ECRI Institute on June 2, 2008. The updated information was verified by the guideline developer on June 23, 2008.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.