New Findings Make Prostate Cancer Screening Even More Confusing

September 12, 2008 04:22 PM
by Cara McDonough
Recent advice that men over 75 should skip prostate cancer screening and an ongoing debate about the blood test for the disease leave many questions unanswered.

Late-Life Screenings, PSA Test Debated

Prostate cancer screening has led to high detection levels, with more than 218,000 men in the United States diagnosed with the disease last year. But new research may leave many older men wondering if they need to be tested, as well as about the accuracy of the blood test for the disease.

Because prostate cancer progresses so slowly, researchers have recently suggested that there is no advantage in screening men who have less than 10 years to live, because aggressive prostate cancer treatment can greatly reduce a patient’s quality of life, often leading to complications like impotence and incontinence. The U.S. Preventive Services Task Force issued a report this week saying that the benefits of screening men over 75 “are small to none,” reports the Associated Press.

And for men questioning the new recommendation, there is even more confusion. There has been a debate for years over the “somewhat imprecise” blood screening test for prostate cancer, called the PSA (Prostate Specific Antigen) test. Because a positive PSA test must be confirmed by a biopsy, and there is no way to differentiate aggressive tumors from slow-growing ones, “A number of experts contend patients are being overtreated.”
So what should men do when deciding whether or not to get the test? U.S. News & World Report offers scenarios for what nine types of men of different races and ethnicities and with varying prostate cancer risks should do about screening in light of the new recommendation.

Experts are still up in the air. Screening is “an area of very intense controversy,” said Dr. Durado Brooks, a prostate cancer specialist for the American Cancer Society, to the Associated Press. “There are many doctors who believe staunchly that PSA testing should be done in all men and there are probably an equal number of doctors who believe very much that testing is of limited value.”

Most experts do agree that practitioners should discuss the benefits and potential harm of the test with their patients, and that most men should not be tested before age 50.

Related Topic: Breast cancer exams

Reference: Prostate cancer


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