El análisis del PSA para el cáncer de próstata lleva una recomendación de grado C de USPSTF para hombres de 55 años...
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | BMA-PSA-PROSTATE-USPSTF-SHARED-DECISION |
|---|---|
| Tipo | Relevancia terapéutica |
| Situación | reviewed 2026-05-18 | actionability review required |
| Enfermedades | DIS-PROSTATE |
| Fuentes | SRC-NCCN-GENETIC-FAMILIAL-BREAST-OVARIAN-2025 SRC-NCCN-PROSTATE-2025 SRC-USPSTF-PROSTATE-2018 |
Hechos relativos a la posibilidad de adoptar medidas
| Biomarcador | BIO-PSA-PROSTATE-SCREENING |
|---|---|
| Variante | PSA — Screening de población / toma de decisiones compartida (Grado C de la USPSTF) |
| Enfermedad | DIS-PROSTATE |
| El nivel de ESCAT | IIIA |
| Combinaciones recomendadas | Shared decision making with men 55-69 average risk (USPSTF Grade C), BRCA1/2, ATM, MMR-deficient carriers: earlier screening discussion starting age 40 (BRCA2) / 45 (BRCA1, ATM, Lynch) per NCCN Genetic 2025, Persistently rising PSA: MRI-prostate → MR-targeted + systematic biopsy rather than reflex systematic biopsy (PRECISION trial, Kasivisvanathan 2018) |
| Monoterapia contraindicada | Reflex prostatectomía en el PSA solo para Gleason 6 — la vigilancia activa es el estándar de atención (NCCN Prostate 2025), USPSTF Grado D en hombres ≥70 — no iniciar un nuevo cribado de mayor de 70 años fuera de la toma de decisiones compartidas con una previsión de vida limitada considerada |
| Resumen de las pruebas | PSA screening for prostate cancer carries a USPSTF Grade C recommendation for men aged 55-69 — "small potential benefit" weighed against overdiagnosis / overtreatment harms — and a Grade D (recommendation against) for men ≥70 (USPSTF Prostate 2018). NCCN Prostate 2025 and AUA support shared decision making informed by family history, race (Black men: earlier / more frequent screening discussion), BRCA1/2 and Lynch carrier status (BIO-HRR-PANEL — earlier screening per NCCN Genetic/Familial 2025). Active surveillance for Gleason 6 (Grade Group 1) low-risk disease has replaced reflex prostatectomy. PSA velocity, PSA density, free/total PSA ratio, and reflex tests (4Kscore, PHI, SelectMDx) refine biopsy decisions. ESCAT IIIA — PSA directs screening / biopsy / surveillance decisions but is not a treatment-selection biomarker. |
Notas
STUB pending two-Co-Lead signoff. No standalone IND-PROSTATE-SCREENING- SHARED-DECISION entity exists yet; closest existing surveillance Indications attach to HRR-positive carriers (ind_brca_carrier_surveillance, ind_lynch_carrier_surveillance). A general-population IND-PROSTATE-SCREENING-USPSTF entity (gated on age + risk-factor profile + shared-decision-making questionnaire) is a future authoring task. Engine must NOT auto-recommend PSA screening for asymptomatic men without rendering the USPSTF tradeoff explicitly — overdiagnosis / overtreatment harms are the stated reason for Grade C (not Grade B).
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