55 to 70 years) to discuss screening risks and benefits with their physician, many US cancer centers (26%) recommend that all men universally receive PSA screening (using language such as "annual prostate screening is recommended for men beginning at age 50 years"), without advising shared decisionmaking. Most centers (62%) do not discuss screening risks on their websites.A limitation of this study is that the public recommendations of cancer centers may not reflect their clinical practices. Nevertheless, the divergence between these recommendations and national society guidelines highlights the need to encourage shared decision-making for men considering screening. These findings are similar to the language used by many centers regarding lung cancer screening, generally emphasizing screening benefits more than potential harms and rarely recommending shared decision-making. 5 Because clinical practice guidelines do not make specific recommendations regarding whether men at potentially higher risk owing to family history or race and ethnicity should consider earlier screening, the present analysis was unable to examine this.The pattern of recommendations for PSA screening differs markedly from recommendations around screening mammography provided by breast cancer centers, which diverge from national society guidelines in more than 80% of cases: the majority of centers advise women to undergo earlier, more frequent screening than guidelines. 6 The differences between PSA and mammography screening recommendations illuminate differences in how cancer centers advise men and women considering cancer screening and suggest further exploration of how recommendations differ across sex and cancer.
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