What to know about new advice on prostate cancer test
- Author: Myrtle Hill Apr 12, 2017,
Apr 12, 2017, 3:24
Every man between the ages of 55 and 69 is advised to talk to their doctors about taking the prostate-specific antigen blood test, according to recommendations released Tuesday by the U.S. Preventive Services Task Force.
But experts say that a positive test may leave some confused about what to do next.
An independent US panel of experts has changed course on its recommendation against routine PSA screening of men for prostate cancer.
USPSTF still recommends against screening for men aged 70 and older.
Critics of that recommendation anxious that as a result of any reduction in testing, prostate cancer might be diagnosed at a more advanced stage in some men.
The draft recommendation that the screening holds some potential benefit for men 55 to 69 is a reversal of the USPSTF 2012 controversial recommendations against the screening. Because prostate cancer takes many years to develop, the benefit only becomes apparent 10 to 20 years after the start of a study, he explained.
Good scientific research has bought about improved understanding of cancer and the limitations of screening tests, diagnostics and treatment. If you treated everyone who was diagnosed with prostate cancer, which is what used to be done, most men would not benefit.
Urologist Dr. Edward Schaeffer, an advocate for widespread prostate cancer screening, welcomed the new report.
Nearly 180,000 American men are diagnosed with prostate cancer each year and at least 26,000 die from the disease, making it one of the most common and deadly cancers among men. One epidemiologic study suggests that more than 1 million American men received unnecessary treatment over the past 25 years.
The PSA test measures the level of a protein that, when elevated, can mean prostate cancer is present.More news: USA soldier killed in anti-IS operations in Afghanistan
For more about prostate cancer, visit the American Cancer Society. "Guidelines are needed to ensure that all men have the opportunity to make an informed decision on whether or not to have a PSA test". "These results give us confidence that we really have the full picture of the potential benefits of screening", says Bibbins-Domingo. There are also over-treatments, as well as complications that arise from normal treatments.
Last year, actor Ben Stiller announced that he had had his prostate surgically removed in 2014, after testing revealed that he had developed prostate cancer in his 40s. It's also wrong to say that we should never do PSA testing because it has been shown to save lives. "Literally", he wrote in a blog post.
Once you have a high PSA, whether it's from cancer or not, it leads to biopsies to find out for sure.
"We did them no favors by telling them they had cancer and giving them surgery", he added. The task force said physicians should inform their patients of the risks and benefits associated with screening, and they should decide on the best course of action together.
The American Academy of Family Physicians will conduct its own review of the evidence.
The panel leaves open how often men should be screened. Bibbins-Domingo said the largest European studies have generally screened every two to four years. That's how we approach the subject of PSA testing at MSK. Men with a family history of prostate cancer would also fall into this category.
One specialist views the new recommendation as a correction of an error the task force made in 2012.
Brawley said that, despite the possible harms, patient preference comes first.
"At risk patients (men with a family history and black men) are more likely to die from prostate cancer, therefore these individuals are conceptually more likely to gain from PSA screening", Trinh, who wasn't involved in the task force recommendations, said by email. Once diagnosed, hopefully patients and their physicians will not rush into treatment but explore and consider all reasonable options.