DEGAM-Praxisempfehlung "Hausärztliche Beratung zu PSA-Screening"

Guidelines for the counseling of men regarding prostate cancer early detection are inconsistent. US institutions state against prostate cancer screening using PSA tests, whereas the German S3 guideline recommends to provide information about prostate cancer screening to men age 45 and older as a matter of principle. Main argument against PSA screening is the high risk for overdiagnosis and overtreatment and at the same time no scientific evidence for a reduction of overall mortality. The DEGAM follows this argument and lodged a dissenting opinion in the S3 guideline. It's the aim of the DEGAM practice recommendation to support family physicians in protecting men from overdiagnosis and overtreatment. Building on the dissenting opinion, it provides evidence based information for the counseling of men. Graphic illustrations may be used as a basis for a shared decision making. Following the DEGAM 3-steps-plan, a S1 guideline for the family physicians' counseling of men regarding PSA screening had been developed on the basis of an earlier version of the S3 guideline. After the S3 guideline had been updated, the S1 guideline was reworked into the now available DEGAM practice recommendation. Recommendations: Men, who don't explicitly ask for prostate cancer early detection, should not be informed proactively. Men, who ask for prostate cancer early detection, should be informed about advantages and disadvantages. Benefits and risks should be explained using natural numbers and graphics. Additionally, the significance of positive and negative test results should be illustrated.