Should The New Guidelines For PSA Screening Be Ignored?

April 26, 2012 by  
Filed under Prostate Cancer News

There has been controversy on the validity of PSA screening that men who are above 75 years of age should go for. This controversy come into being when the U.S. Preventive Services Task Force recommended that testing for PSA for men 75 and above is not necessary. The reason being that this group of people has low life expectancy and that the PSA level in the blood may give bias result in diagnosing cancer of the prostate.

 It seems as if this guideline has failed and the Task force is set to issue another guideline that could be stricter than the former. Will this end the controversy? Many men still go for PSA screening as a matter of necessity ignoring the call by the US task force. Here is an extract revealing the unnecessary testing and hint on the new guidelines for PSA screening:

In 2008, the U.S. Preventive Services Task Force recommended against testing for prostate cancer in men aged 75 and older, but new research finds that almost 44 percent of these men are still being screened.

Before the 2008 guidelines were set, about 43 percent of men in this age group opted for prostate-specific antigen (PSA) tests, but the task force found that testing had no effect on longevity and could result in overtreatment with adverse consequences. Meanwhile, the task force drafted a new set of guidelines last October that are even more critical of PSA testing, suggesting it may not have any value for men of any age.

“Patients and providers did not adjust their screening behavior following the last major United States Preventive Services Task Force recommendation, and the effect of the upcoming guideline needs to be monitored,” said study author Dr. Sandip Prasad, a urologic oncology research fellow at the University of Chicago Medical Center.

“Many physicians and patients continue to have confidence in PSA screening to prevent death from prostate cancer, and it is incumbent upon the medical community to refine the use of this screening test to minimize overdiagnosis and overtreatment of prostate cancer without losing ground on the progress we have made against the disease,” he added.

The findings were published in a letter in the April 25 issue of the Journal of the American Medical Association.

Prasad’s team found that the number of older men receiving PSA tests had actually increased to 43.9 percent by 2010. That’s more screening than in men in their 40s and 50s (12.5 percent and 33.2 percent, respectively) who are the ones most likely to benefit from early diagnosis and treatment, the researchers said.

Only men aged 60 to 74 were more likely to get a PSA test (51.2 percent), they noted.

To gather the data, the researchers used the 2005 and 2010 Cancer Control Supplements, which are part of the annual National Health Interview Survey.

Because patient data is self-reported, the results likely underestimate the actual number of men getting PSA screening, the researchers noted.

The U.S. Preventive Services Task Force is on the verge of issuing new PSA testing guidelines and, based on early recommendations, the task force now believes the PSA test is ineffective for men of any age. Click here to read the full article.

So, with this development, it becomes difficult and confusing to know what angle to choose. The PSA test is still helpful as an introductory diagnostic option for prostate cancer. Even as its results cannot be completely relied upon, it is non the less still relevant in prostate diagnoses. The opinion of Dr Anthony D’Amico in the extract above is highly commendable and he is very frank in his comments.

Finally, PSA is still a very important, and I think that new guidelines should not be confusing because most people already knows the benefits of getting early screening of their PSA level.

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