PSA test distress, study urges caution

Apr 9 2010

By Candy Lashkari

A new study wants men to be informed about risks associated with screening for prostate cancer. The research has brought out that the prostate cancer tests can cause significant psychological distress to the men undergoing the screening. 330 men were studied by the University of Bristol as they underwent the tests and after they finished.

The study findings were concluded in an article in the British Journal of Cancer where it was stressed that the men should be given warnings about the distress that they might experience from a PSA test. An elevated level of prostate-specific antigen (PSA) indicates prostate cancer and may require a biopsy. In 70% of the cases there is no cancerous growth. Despite having a negative result some men still felt psychologically disturbed.

Prostate-specific antigen is a protein produced by the cells of the prostate gland. PSA is present in small quantities in the serum of normal men, and is often elevated in the presence of prostate cancer and in other prostate disorders. A blood test to measure PSA is currently considered the most effective test currently available for the early detection of prostate cancer.

The study also seeks to review the current NHS policy of testing on request as it was found that 20% deaths could be averted due to timely screening. Currently men over 45 can request for a screening if they wish, but many of them do not go in for the screening tests due to the psychological and psychological ramifications.

Professor Kavita Vedhara, who led the research said, “We found that in some men, the psychological effects lasted even after the men were told their biopsy was benign. It's essential that doctors know about this, and that men are fully informed of the psychological challenges they may face during and after a PSA test."

Most men who underwent the screening did not speak with their doctors about the effects of the screening. Only 20.6% of the men spoke about the pros and cons of screening with their doctors. And even when they did speak, the doctors were 71.4% of the time more likely to emphasize the benefits of the screening process rather than discuss the risks such as incontinence and sexual dysfunction with the patients. The risks were only discussed 32% of the time.

Making an informed health decision was the push of the study. Cancer Research UK, which funded the research carried out by the University of Bristol, said: "This study shows just how important it is that men in their 50s and 60s can talk to their doctors about the pros and cons of having a PSA test and only have the test if they feel it is right for them."

Dr Helen Rippon of the Prostate Cancer Charity said, "It is vital that all men considering a PSA test are fully aware of its impact. We must move swiftly to a position of 'universal informed choice' where all men are made aware of their right to request a test and to be given clear information about its usefulness and limitations so they can decide whether having the test is right for them,"