{"entity":{"id":"paper-moyer-uspstf-prostate-screening-ann-intern-med-2012","kind":"paper","name":"USPSTF 2012: screening for prostate cancer, recommendation statement (grade D)","aka":["USPSTF 2012 prostate","Moyer 2012","grade D prostate screening"],"tldr":"In 2012 the American preventive services body recommended against PSA screening for every man at every age. It is the most consequential negative screening recommendation ever made, and it was reversed six years later.","summary":"The United States Preventive Services Task Force, reporting through Virginia Moyer, updated its 2008 statement after reviewing the evidence on the benefits and harms of prostate-specific antigen screening and of treating screen-detected localised disease. The recommendation was grade D: recommend against, for men in the general United States population regardless of age.\n\nThe statement was made in the light of PLCO, which had found no mortality benefit, and ERSPC, which had found a small one at a high cost in overdiagnosis. Prostate-specific antigen testing and prostate biopsy rates fell in the United States afterwards, and so, over the following years, did the proportion of cancers diagnosed at a localised stage. The 2018 update (paper-uspstf-prostate-screening-jama-2018) moved men aged 55 to 69 to grade C, shared decision-making, and left men aged 70 and over at grade D.","asOf":"2026-09-25","links":[{"label":"Ann Intern Med 2012","url":"https://doi.org/10.7326/0003-4819-157-2-201207170-00459"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/22801674/"},{"label":"USPSTF: prostate cancer screening","url":"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening"}],"tags":["prostate-evidence"],"related":["paper-uspstf-prostate-screening-jama-2018","paper-andriole-plco-prostate-screening-nejm-2009","paper-schroder-erspc-screening-mortality-nejm-2009","prostate-roadmap"],"cancers":["prostate","prostate-low-risk"],"sections":["early-detection","prevention"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["psa","screening","overdiagnosis","overtreatment","lead-time-bias"],"trials":[],"people":[],"bottlenecks":["b-overdiagnosis","b-early-detection","b-prevention-adoption","b-knowledge-diffusion"],"keyPapers":[],"journals":["annals-internal-medicine"],"dependsOn":[],"notes":[],"journal":"Annals of Internal Medicine","year":2012,"doi":"10.7326/0003-4819-157-2-201207170-00459","pmid":"22801674","authors":"Moyer VA, U.S. Preventive Services Task Force.","paperType":"guideline","findings":["Grade D recommendation: the task force recommends against prostate-specific antigen-based screening for prostate cancer.","The recommendation applied to men in the general United States population regardless of age.","It did not cover use of the prostate-specific antigen test for surveillance after diagnosis or treatment, which was outside the task force's scope.","It updated the 2008 statement after review of new evidence on the benefits and harms of screening and of treating localised screen-detected disease."],"whatItMeans":"The clearest case in cancer screening of a national body acting on the harms rather than the headline. Whether it was right is still argued: testing and localised-stage diagnosis fell, and the long-term effect on metastatic presentation and mortality is the subject of the studies that followed.","caveats":["A recommendation statement, not new evidence; it rests on the screening trials and the lead-time models, which are recorded separately.","A blanket recommendation across all ages and risk groups, including men at high familial or ancestral risk, which is the criticism that drove the 2018 revision.","United States practice; other countries reached different conclusions from the same trials."],"changedPractice":true},"route":"/key-papers/paper-moyer-uspstf-prostate-screening-ann-intern-med-2012/","neighbours":{"paper":[{"id":"paper-schroder-erspc-screening-mortality-nejm-2009","kind":"paper","name":"ERSPC: screening and prostate cancer mortality in a randomised European study","route":"/key-papers/paper-schroder-erspc-screening-mortality-nejm-2009/"},{"id":"paper-andriole-plco-prostate-screening-nejm-2009","kind":"paper","name":"PLCO: mortality results from a randomised prostate cancer screening trial","route":"/key-papers/paper-andriole-plco-prostate-screening-nejm-2009/"},{"id":"paper-uspstf-prostate-screening-jama-2018","kind":"paper","name":"USPSTF 2018: screening for prostate cancer, recommendation statement (grade C at 55 to 69, grade D at 70 and over)","route":"/key-papers/paper-uspstf-prostate-screening-jama-2018/"}],"roadmap":[{"id":"prostate-roadmap","kind":"roadmap","name":"Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch","route":"/roadmaps/prostate-roadmap/"}],"cancer":[{"id":"prostate-low-risk","kind":"cancer","name":"Localised prostate cancer, very low and low risk","route":"/cancers/prostate-low-risk/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"},{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"term":[{"id":"lead-time-bias","kind":"term","name":"Lead time, and lead-time bias","route":"/terms/lead-time-bias/"},{"id":"overdiagnosis","kind":"term","name":"Overdiagnosis","route":"/terms/overdiagnosis/"},{"id":"overtreatment","kind":"term","name":"Overtreatment","route":"/terms/overtreatment/"},{"id":"psa","kind":"term","name":"PSA (prostate-specific antigen)","route":"/terms/psa/"},{"id":"screening","kind":"term","name":"Screening","route":"/terms/screening/"}],"bottleneck":[{"id":"b-knowledge-diffusion","kind":"bottleneck","name":"Knowledge reaches practice too slowly","route":"/bottlenecks/b-knowledge-diffusion/"},{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"},{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"journal":[{"id":"annals-internal-medicine","kind":"journal","name":"Annals of Internal Medicine","route":"/journals/annals-internal-medicine/"}]}}