prostate screening

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mtb says no screening is recommend cause it doesn't lower mortal.
yet uw says screen with dre and pas b/w 50-70.
what is right?
 
mtb says no screening is recommend cause it doesn't lower mortal.
yet uw says screen with dre and pas b/w 50-70.
what is right?

DRE should be part of a complete physical exam. I don't know that you get a PSA unless the patient is experiencing urinary flow issues or nocturia because the test is low sensitivity.
 
You have to remember that the board questions are not always current and are at times 3 years behind. 3 years ago PSA screening was still standard in many parts of the country.
 
Yes, but even at that time the American Cancer Society recommended against routine screening, and there has never been strong evidence for the practice. In my experience with all three Steps, I think there is very strong evidence behind anything they test you about.
 
Actually, my last comlex test asked me about prostate screening, PSA values, and what values indicated biopsy. My jaw about hit the floor since the issue has become so controversial. My urologist friend gets a baseline value, rechecks in 6mo-1yr, and then biopsies anybody whose value raises sharply sans another reason (prostatitis, s/p TURP, etc.)

Other places biopsy anybody with a PSA between 4-10ng/ml... although the value is age specific, and this practice is controversial. The major colleges all seem to have different opinions on the subject, and some simply have no recommendation at all, or the recommendation is non-specific. (USPTF)

According to the guys at premier review, the level 3 test is only about 6 months behind times. This differs from steps 1 and 2 which are less time sensitive. In general, the more clinical the test, the more time sensitive it becomes. This fact then (as usual) reflects poorly on comlex.
 
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