Concerns about overdiagnosis of clinically insignificant prostate cancer through prostate specific antigen (PSA) screening motivated the 2018 American Academy of Family Physicians’ (AAFP) recommendation against routine screening for prostate cancer. Explaining the AAFP’s position, Drs. James Stevermer and Kenneth Fink
I am hoping that molecular studies will eventually help us better distinguish between prostatic adenocarcinomas that have little metastatic potential from those which have high metastatic potential. Patient age and Gleason Score/Grade Group, while helpful, don't quite get us there.
These types of studies certainly have helped with other indolent cancers - I'm thinking thyroid cancer, which is also overdiagnosed but it seems that we have a better understanding of when to treat aggressively than prostate cancers.
In clinical practice, looking for (and finding) prostate cancer is not a challenge. Having a meaningful conversation about life expectancy can be.
I am hoping that molecular studies will eventually help us better distinguish between prostatic adenocarcinomas that have little metastatic potential from those which have high metastatic potential. Patient age and Gleason Score/Grade Group, while helpful, don't quite get us there.
These types of studies certainly have helped with other indolent cancers - I'm thinking thyroid cancer, which is also overdiagnosed but it seems that we have a better understanding of when to treat aggressively than prostate cancers.