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Cancer Test Gets Bad Reviews

US Preventive Services Task Force recommends against a commonly used prostate cancer screening.

By | May 22, 2012

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Prostate cancer screening based on the prostate-specific antigen (PSA) blood test was given a D grade by the independent group that assesses clinical practice and advices the US government, reported Nature.

The US Preventive Services Task Force (USPSTF) now recommends that most men do not get screened via the PSA test, which measures the amount of PSA, an enzyme produced by the prostate gland, in the blood. Risk of prostate cancer increases with increasing PSA levels, but benign prostate enlargement or prostate infection can also prompt an increase in PSA serum levels. As a result, the USPSTF found, PSA screening leads to false positive diagnoses and avoidable complications from biopsies and cancer treatment that may never have been warranted. According to the USPSTF’s calculations, for every 1,000 men screened, 1 life will be saved, between 30 and 40 men will experience erectile dysfunction or incontinence from unnecessary medical treatments, 2 will suffer serious cardiac events, and 1 man will have a blood clot. For every 3,000 men screened, 1 will die from surgical interventions. Given that most tumors detected by the blood test are slow-growing, these risks do not outweigh the benefits, the USPSTF concluded.

Many urologists disagreed with this assessment, however. In a commentary accompanying the USPSTF’s recommendation, published this week (May 21) in the Annals of Internal Medicine, urological specialists argued that screening should be recommended because prostate cancer is the second leading cause of cancer deaths among men. The authors argue especially that the USPSTF did not give enough consideration to high risk populations.

“It is inappropriate and irresponsible to issue a blanket statement against PSA testing, particularly for at-risk populations, such as African American men,” the American Urological Association said in a statement. “Men who are in good health and have more than a 10–15 year life expectancy should have the choice to be tested and not discouraged from doing so.” The USPSTF, in turn, argued for more research that could help refine the test, such that it produces fewer false positives and distinguishes more lethal fast-growing tumors from slow-growing tumors with little impact on health.

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Comments

Avatar of: franklinleach

franklinleach

Posts: 1

May 23, 2012

The members of the Temple prostate support believe in the PSA test. The committee did not have a urologist on it.
From USTOO - a prostate support group "Research
from the National Cancer Institute has shown that as much as 70 percent
of the drop in prostate cancer deaths since 1975 can be attributed to
PSA screening. And research based on data from Sweden
and Denmark, published in the Journal of Clinical Oncology and
elsewhere, shows that even a single PSA test given between the ages of
44 to 50 can help predict the future diagnosis of prostate cancer."
There are difficulties with the PSA test.  There are many types of prostate cancer. Mine was most aggressive and I am glad that a PSA test raised a flag. The DRE did not seem lie a cancer, but the biopsy was positive. Radical surgery, anti androgen treatment, radiation, and now provenge.
 It isn't simple and making great pronouncements to cover everything isn't personalized medicine/

Avatar of: jakcyly

jakcyly

Posts: 1

May 25, 2012

Research can have a bigger breakthrough, make a big contribution to human health!Franklin Marshall

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