In December of 2011 the National Institute of Health (NIH) released a draft State-of-the-Science Conference Statement.  The focus of the study was on PSA-based screening which has identified many men with low-risk prostate cancer.  Over the past decade active surveillance has emerged as a viable option for men with low-risk prostate cancer. This represents approximately 100,000 men diagnosed in the United States each year.  Despite the very favorable prognosis of low-risk prostate cancer, many men with low-risk disease continue to opt for or are only offered treatments such as radical prostatectomy or radiation therapy which can lead to side-effects such as impotence and incontinence in a substantial number of men.  The NIH draft statement suggests that strong consideration be given to removing the anxiety-provoking term “cancer” for low-risk prostate cancer.  This means that men who today would be diagnosed with low-risk prostate cancer would no longer be considered cancer survivors and would likely automatically undergo either Active Surveillance or Watchful Waiting (depending on age and other co-morbidities).   This could also cut prostate cancer incidence in half.

Prior to this the U.S. Preventive Services Task Force (USPSTF) released a draft position statement based on their review of several large prostate cancer screening trials.  The USPSTF, following a standardized protocol, developed an analytic framework to explore key questions such as: the effectiveness of PSA-based screening in decreasing prostate cancer–specific or all-cause mortality; the harms that may be set forth as a result of PSA-based screening; the benefits of treating early-stage or screening-detected prostate cancer; and the harms of treating of early-stage or screening-detected prostate cancer.  Recommendations were based on 2 fair-quality and 3 poor-quality randomized trials of PSA-based screening.  While study contamination makes accurate evaluation of PSA as a tool to find cancer early and thereby treat it more effectively almost impossible, these studies clearly de