By rray, 2 August, 2024 Exclude Patient Type Detail Header No Detail Type Text Detail Text If pt can t decide clinician can decide based on pt s general health preferences and values 2 ACP says don t screen if pt doesn t express clear preference 12 If average risk pt inquires about PSA screening and is 50 69 yo Offer one time discussion on limited potential benefit and substantial harms have more discussions if pt requests them 1 AUA13 strongly recommends offering pts 50 69 yo regular screening q2 4y SR AUA A USPSTF4 recommends individualized decision making in pts ages 55 69 yo Discuss potential benefits and harms of screening and consider pt s values and preferences Don t screen pts who don t express preference for screening If Black African American reasonable to begin discussing PSA screening at age 40 and consider screening q1y 3 5 although no current evidence shows that testing at an earlier age will darr morbidity and mortality vs testing at age 45 and earlier screening The BMJ Rapid Recs team notes that pts who place more value on avoiding complications from bx and CA tx are likely to decline screening In contrast pts who put more value in even a small reduction of prostate CA mortality i e those at high baseline risk b If known suspected germline mutation e g BRCA2 BRCA1 ATM CHEK2 PALB2 HOXB13 MLH1 MSH2 MSH6 PMS2 EPCAM and TP53 refer to CA genetics specialist 3 Factors that might raise PSA levels 9 older age BPH prostatitis ejaculation bike riding urological procedures meds testosterone or meds that raise testosterone levels Factors that might lower PSA levels 3 9 meds 5 reductase inhibitors herbal mixtures dietary supplements but not saw palmetto aspirin statins thiazides DRE has no effect on PSA levels 8 Patient Type Detail Header (Long) Screening considerations
