Screening and management of prostate cancer in elderly men: the Iowa Prostate Cancer Consensus.
OBJECTIVE
The issue of prostate cancer screening and management is likely to assume greater importance with progressive aging of the population. Because there are no currently established guidelines for screening and management of prostate cancer in elderly men (older than 75 years), a multidisciplinary panel was convened to develop consensus recommendations.


METHODS
The panel consisted of experts in urology, internal medicine/geriatrics, medical oncology, radiation oncology, family practice, law, patient advocacy and physician assistants. Four internationally known experts on prostate cancer served as external advisors. Relevant literature was reviewed and consensus was developed based on expert opinion, given the lack of level I evidence regarding most aspects of prostate cancer diagnosis and management in men older than 75 years of age.


RESULTS
On the basis of the opinions of the expert panel, recommendations for screening and management of prostate cancer in elderly men older than 75 years of age was developed. In general, there was support for using greater discretion in screening for prostate cancer in elderly men. The lack of adequate patient education tools to facilitate discussion with patients was recognized. There was also agreement on the need for greater and renewed patient counseling regarding benefits and risks of prostate cancer screening beyond age 75.


CONCLUSIONS
It is possible to build consensus around a standardized approach to prostate cancer screening and management in older men. Promulgation of such consensus recommendations and their widespread adoption may help engender a tailored approach to managing prostate cancer in older men, thereby decreasing health care costs and morbidity while limiting unnecessary therapy.
Konety
Badrinath R
BR
University of Iowa Department of Urology, Iowa City, Iowa, USA. bkonety@urology.ucsf.edu
Sharp
Victoria J
VJ
Raut
Hrishikesh
H
Williams
Richard D
RD
D000368:Aged; D006801:Humans; D008297:Male; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*