A new recommendation that healthy men should no longer receive a PSA blood test to screen for prostate cancer drew criticism Friday from a University of New Mexico specialist who says the screening saves lives.
The draft recommendation by the U.S. Preventative Services Task Force reports that the PSA test has done little to reduce cancer deaths and too often leads to harmful testing and treatments that provide no benefit.
The test identifies high levels of PSA, or prostate-specific antigen, a protein produced by the prostate gland that signals the presence of cancerous cells in the prostate. The test is routinely given to men over 50.
The guidelines, based on a review of five clinical studies, conclude that many men who have cancerous cells in their prostate glands will suffer no ill effects because the cancer is slow-growing.
The guidelines also warn that further testing can lead to impotence, incontinence, infections, even death from biopsies, surgery or radiation. Consequently, the guidelines recommend that no healthy men should receive the PSA test.
Dr. Satyan Shah, a UNM Cancer Center urologist who specializes in prostate cancer, said the test has proven itself since the late 1980s as an important tool for diagnosing prostate cancer, which remains the second-leading cause of cancer deaths in men.
Each year, 223,000 men in the United States are diagnosed with prostate cancer and 29,000 die of the disease, according to the Centers for Disease Control and Prevention.
Before widespread adoption of the PSA test, prostate cancer “was only diagnosed when abnormalities were noted on a patient’s physical exam, or men came in with very severe symptoms of prostate cancer,” Shah said.
The test has led to successful treatments in earlier stages of prostate cancer, he said. “In the PSA era, we know that the rates of prostate cancer mortality have dropped dramatically.”
The guidelines also ignore high-risk groups, such as men with a family history of prostate cancer, who could benefit from the test, Shah said.
“We all recognize that not everybody with an abnormal test needs to have something done next,” he said. “But that’s a conversation that a cancer doctor needs to have with a patient.”
Dr. Virginia Moyer of the Baylor College of Medicine, who headed the task force that wrote the draft guidelines, said physicians should focus on finding a better test for diagnosing dangerous prostate cancer.
About a third of men ages 40 to 60 have brewing prostate cancer, but “the huge majority of them will never know it in their lifetime if they are not screened,” Moyer said.
The Associated Press contributed to this report.
— This article appeared on page C1 of the Albuquerque Journal
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