IMPLICATIONS FOR NURSES
Oncology nurses’ role as educators becomes more significant in regard to explaining to patients the change in the recommendations regarding PSA screening. “Nurses are in a position to help inform patients and extend conversations that physicians may not have time for,” Dr Carter told Oncology Nurse Advisor.
The authors of the new recommendations write that when deciding if PSA screening is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history. Other factors that must be considered are race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs, write the authors.
Prostate cancer mainly develops in older men and in African-American men. The American Cancer Society (ACS) reports that approximately 6 cases in 10 are diagnosed in men aged 65 or older, with an average age at diagnosis of 66. Currently, prostate cancer is ranked as the second leading cause of cancer death in American men, and approximately 1 man in 41 will die of the disease.
“The take-home message is that men should have some understanding that PSA testing for prostate cancer detection is associated with both harm and benefit. Thus, patients should express preferences prior to decision-making,” said Dr Carter.
Fenton JJ, Weyrich MS, Durbin S, Liu Y, Bang H, Melnikow J. Prostate-specific antigen-based screening for prostate cancer evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319(18):1914-1931.