Panel Advises Against Prostate Cancer Screening

WASHINGTON (AP) – No major medical group recommends routine PSA blood tests to check men for prostate cancer, and now a government panel is saying they do more harm than good and healthy men should no longer receive the tests as part of routine cancer screening.

The panel’s guidelines had long advised men over 75 to forgo the tests and the new recommendation extends that do-not-screen advice to healthy men of all ages.

The recommendation by the U.S. Preventive Services Task Force, being made public on Friday, will not come as a surprise to cancer specialists.

Yet, most men over 50 have had at least one PSA blood test, the assumption being that finding cancer early is always a good thing.

Not so, said Dr. Virginia Moyer of the Baylor College of Medicine, who heads the task force.

“We have put a huge amount of time, effort and energy into PSA screening and that time, effort and energy, that passion, should be going into finding a better test instead of using a test that doesn’t work,” Moyer told The Associated Press late Thursday.

Too much PSA, or prostate-specific antigen, in the blood only sometimes signals prostate cancer is brewing. It also can mean a benign enlarged prostate or an infection. Worse, screening often detects small tumors that will prove too slow-growing to be deadly. And there’s no sure way to tell in advance who needs aggressive therapy.

The task force analyzed all the previous research on this subject, including five major studies, to evaluate whether routine screening reduces deaths from prostate cancer. The conclusion: There’s little if any mortality benefit.

But there is harm from routine screening: impotence, incontinence, infections, even death that can come from the biopsies, surgery and radiation, Moyer said.

One study estimated 2 of every 5 men whose prostate cancer was caught through a PSA test had tumors too slow-growing to ever be a threat.

Yet Moyer said 30 percent of men who are treated for PSA-discovered prostate cancer suffer significant side effects, sometimes death, from the resulting treatment.

About a third of men ages 40 to 60 have brewing prostate cancer but “the huge majority of them will never know it in their lifetime if they are not screened,” she added.

The task force previously had considered the evidence for or against PSA screening inconclusive. The new recommendation says not to routinely screen. That recommendation is a draft that is open for public comment beginning next week.

“We have been long concerned, and it has been apparent for some years, that some supporters of prostate cancer screening have overstated, exaggerated and in some cases misled men about the evidence supporting its effectiveness,” said Dr. Otis Brawley of the American Cancer Society in a statement. “We need balanced, truthful information to be made widely available to physicians and patients when making important health decisions.”

The society had not seen the new recommendation yet, but has long advised men to consider the pros and cons of PSA screening before deciding on their own.

Moyer said the recommendation only means that doctors shouldn’t bring up the option for healthy men. If a man asks for a PSA test and wants it after being informed of the evidence, he should receive it, she said. Likewise, it’s appropriate to use PSA tests to examine a man with possible prostate symptoms.

(© Copyright 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

  • C Bauer

    This is more ammo to my assertion that you need to live the way you want to live. George Burns had 8 cigars and 6 martinis on average every day of his adult years and lived to be 100. Frank Sinatra – also “hard living” and a long life. Shane MacGowan? STILL ALIVE!

    I eat steak thrice weekly, love my Chateau Mouton, Luksusowa martinis, and smoke cigars on the weekends. When your number is up, your number is up. There’s NOTHING you can do about it, for or against. LIVE, BABY, LIVE!

  • Panel Advises Against Prostate Cancer Screening « Fort Worth News Feeds

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  • David

    True, very true Mr Bauer. But now lawmakers(insurance companies) have launched a new war on tobacco users. And it won’t be long before the Twinkie police come knocking.

    “Great dictatorships always allow the freedom of choice. You can either do exactly what they tell you to do, or you can suffer the consequences.” –Me

    • IP Lawyer

      Nice quotation! You need to copyright that.

  • Dave Duluth

    As a 70 year old man who had prostate cancer my response is: Without the PSA annual test (which jumped 3/4 of 1% in 1 year) I would not have been alerted to the fact that I might have a prostate cancer situation. Next step was to have prostate biopsey in which 1 of the 10 samples was positive for cancer cells. After considering the options I elected to have the prostate removed from my body as I do NOT want to give the cancer cells in the prostate an opportunity to spread to some place else in my body. NO “Watchful waiting”!!! PSA testing is the ONLY initial indicator for possible prostate cancer and is a VERY necessary test.

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