Value of prostate cancer screening test not proven says report

June 29, 7:37 AMCharlotte Health and Happiness ExaminerKathleen Blanchard RN

A new report suggests that the prostate cancer screening test, prostate specific antigen (PSA) has minimal value when it comes to finding prostate cancer, especially in older men. The report, published in CA: A Cancer Journal for Clinicians shows that routine PSA blood tests result in overdiagnosis of prostate cancer, resulting in unnecessary treatments , psychosocial harm, and treatments that are not needed, related to insignificant prostate cancer tumors.

Though deaths from prostate cancer have declined since the 1980’s, study authors Otis W. Brawley, M.D. of the American Cancer Society and Donna Ankerst, Ph.D. and Ian M. Thompson, M.D. of the University of Texas Health Science Center at San Antonio, say the contribution of prostate cancer screening, using PSA blood tests, does not reduce the risk of suffering from prostate cancer.

The study authors also say in the future prostate cancer screening should improve to include better screening methods, assessment of prostate cancer risk factors and treatment of urinary symptoms with the drug finasteride, used to for men with enlarged prostate.

PSA tests reduce lifetime risk of dying from prostate cancer from three percent to just 2.4 percent. In a related editorial, Peter Boyle, Ph.D., D.Sc., of the International Prevention Research Institute, Lyon, France and report co-author Dr. Brawley say "the real impact and tragedy of prostate cancer screening is the doubling of the lifetime risk of a diagnosis of prostate cancer with little if any decrease in the risk of dying from this disease."

According to the American Cancer Society, “There can be different reasons for an elevated PSA level, including prostate cancer, benign prostate enlargement, inflammation, infection, age, and race”, all factors that make PSA test results confusing, leading to potential for unnecessary treatment and suffering when tests are elevated.

The authors conclude, "men should discuss the now quantifiable risks and benefits of having a PSA test with their physician and then share in making an informed decision”. They contend that prostate cancer screening tests are not meeting the standard of reducing health care costs, or risk of death and suffering from prostate cancer .

CA Cancer J Clin, July/Aug 2009 doi:10.3322/caac.20026

Resource: http://www.cancer.gov/cancertopics/factsheet/detection/PSA