Aug 5 2008
The latest information regarding the PSA (prostate-specific antigen) test for prostate cancer, is advising men age 75 and older not to be screened.
It also says younger men should discuss the benefits and harms of the PSA test with their doctors before being tested.
The new recommendation comes from the U.S. Preventive Services Task Force which has found evidence that screening for prostate cancer provided few health benefits but led to substantial physical and some psychological harm in men age 75 and older.
The Task Force says for men younger than 75, the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.
Prostate cancer is the most common type of cancer that afflicts Australian men and the second highest cause of cancer deaths in men.
Screening for prostate cancer is most often performed using PSA tests and digital rectal exams and while the PSA test is more likely to detect prostate cancer than the digital rectal exam, prostate cancers that are found with a PSA test take years to affect the health.
Most prostate cancers that grow serious enough to cause death take more than 10 years to do so and the researchers say as a 75-year-old man has an average life expectancy of about 10 years he is more likely to die from other causes such as heart disease or stroke, and prostate cancer screening is unlikely to help men over 75 live longer.
Men younger than 75 with chronic medical problems and a life expectancy of fewer than 10 years are also unlikely to benefit from screening.
The researchers say prostate cancer screening, may include biopsies, unnecessary treatment and false-positive results that may lead to anxiety and complications often result from treating prostate cancer which can manifest as urinary incontinence and impotence.
The researchers say that slow-growing prostrate cancers may never affect a patient's health or well-being had they not been detected by screening and in many cases early detection may may even cause harm.
The researchers men younger than 75 should discuss with their doctor the potential but uncertain benefits and the possible harms of getting the PSA test before they are screened.
This research is the first by any group to define an explicit age cutoff above which screening is likely to be ineffective or harmful and should help to clarify the potential benefits of screening in men under the age of 75.
The Task Force recommendations and accompanying evidence appear in the current issue of the Annals of Internal Medicine.
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