Study Questions Prostate Cancer Screening PSA Tests for Older Men
About one-third of men ages 75 and older receive laboratory blood tests for prostate cancer each year, although the tests provide no benefit for men in that age group, according to a study published Wednesday in the Journal of the National Cancer Institute, the Pittsburgh Post-Gazette reports (Woods, Pittsburgh Post-Gazette, 12/3). In the study, led by Dr. Siu-Long Yao, a genital-urinary oncologist at the Cancer Institute of New Jersey, researchers examined data from a National Health Interview Survey of 7,889 men and found that 32.5% of men ages 75 and older received prostate-specific antigen tests (Recer, AP/Las Vegas Sun, 12/3). According to the study, 88.4% of participants ages 75 and older who received PSA tests said that their physicians recommended the tests, but only 66.5% discussed the advantages and disadvantages of the tests with their physicians. PSA tests, which measure the level of the PSA enzyme in the blood, have "long been steeped in controversy" because although raised levels of the enzyme can indicate the presence of prostate cancer, they also can indicate benign conditions, such as inflammation of the prostate, the Newark Star-Ledger reports (Stewart, Newark Star-Ledger, 12/3). Confirmation of the presence of prostate cancer requires a biopsy or other procedure (Pittsburgh Post-Gazette, 12/3). Yao said that men ages 75 and older would not likely benefit from PSA tests, in large part because of their age, and that the tests could cause patients "unnecessary anxiety" or "harm from aggressive cancer treatments," the Star-Ledger reports (Newark Star-Ledger, 12/3). "There is no evidence that screening men of this age would be beneficial to them, so this may not be the best use of health care resources," Yao said (AP/Las Vegas Sun, 12/3). Yao added, "We don't know exactly why physicians continue to recommend the test. One hypothesis is that physicians are afraid of being sued" (Pittsburgh Post-Gazette, 12/3). An abstract of the study is available online.
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