Prostate Cancer Screening: Concerns with the Canadian Task Force Guidelines

In 2014, The Task Force guideline recommended against PSA screening.

Despite many advances in the field since then, and a neutral to favorable view of screening expressed by virtually every other guidelines group around the world, the Task Force has not re-visited this issue. There are now thousands of publications on the topic of PSA screening that are relevant to the question. Despite many nuances and complexities around the question of prostate cancer screening, the Task Force, by design, does not include any experts with a background in prostate cancer.

Prostate cancer mortality has dropped significantly over the last 20 years. This has occurred to a significant degree as a result of earlier detection with PSA. The Task Force’s recommendation goes against that of the Canadian Urological Association and the US Preventive Services Task Force, both of which acknowledge the benefit of early detection with PSA, and encourage patients to become informed on the subject and make their own decision about whether to be screened. The highly inconsistent recommendations between different bodies creates confusion for patients and physicians and undermines efforts to identify high risk groups who particularly stand to benefit from PSA testing.

We believe this very problematic situation largely reflects the reluctance of the Task Force of incorporate expert opinion with individuals with deep familiarity with the field, into their decision making process.

Dr. Laurence Klotz, CM, MD, FRCSC
Professor of Surgery, University of Toronto
Sunnybrook Chair of Prostate Cancer Research
Chair, Council for Academic Freedom, University of Toronto (CAFUT)
Member, Order of Canada
Sunnybrook Health Sciences Centre

PSA Screening Pocket Guide

Expert Recommended Guidelines

For Expert-Recommended Guidelines, please click here.

 

Expert Statements

Fred Saad, CQ MD FRCS FCAHS

● Professor and Chairman, Department of Surgery, University of Montreal
● Raymond Garneau Chair in Prostate Cancer Research, University of Montreal
● Director of GU Oncology, Division of Urology, University of Montreal Hospital Center (CHUM)
● Director, Prostate Cancer Research, Montreal Cancer Institute/CRCHUM
● Past President of the Canadian Urologic Association
● Past Chairman of the NCIC-GU group