Prostate cancer tests for healthy men? U.S. panel says no

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(CBS/AP) Health experts gave a big thumbs down to routine PSA blood tests for prostate cancer screening saying it might not work and it can do more harm than good.

Pictures: Prostate Cancer Self-Defense: Nine Deadly Myths

The U.S. Preventive Services Task Force, a non-federal panel of medical experts, had long advised men over 75 to forgo the tests. The new recommendation extends that "do-not-screen" advice to healthy men of all ages. Most men over 50 have had at least one PSA blood test because the assumption has long been that finding cancer early is always a good thing.

Dr. Virginia Moyer of the Baylor College of Medicine, head of the task force, disagrees:

"We have put a huge amount of time, effort and energy into PSA screening and that time, effort and energy, that passion, should be going into finding a better test instead of using a test that doesn't work," she said.

Doesn't work? According to the task force, high levels of PSA - or prostate-specific antigen - in the blood only sometimes signals prostate cancer. But it can also mean an infection or an enlarged prostate. Worse, PSA tests often detect tiny tumors that pose little threat - and there's no way to tell in advance who needs aggressive treatment.

One study the task force reviewed found that two of every five men whose prostate cancer was caught through a PSA test had tumors too slow-growing to ever be dangerous. Another found as much as 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," she added.

The task force analyzed all the previous research on PSA screening to evaluate whether routine tests reduce prostate cancer deaths. They found there's little if any mortality benefit.

But they did find a lot of risks from routine PSA tests: impotence, incontinence, infections, and even death that can come from subsequent biopsies, radiation and surgery. Moyer said 30 percent of men who are treated for PSA-discovered prostate cancer suffer significant side effects.

The task force previously had considered the evidence for or against PSA screening inconclusive.

The new recommendation flat out says not to routinely screen. However if a man asks for a PSA test and wants it after being informed of the evidence, he should receive it, Moyer said. Likewise, it's appropriate to use PSA tests to examine a man with possible prostate cancer symptoms.

"We have been long concerned, and it has been apparent for some years, that some supporters of prostate cancer screening have overstated, exaggerated and in some cases misled men about the evidence supporting its effectiveness," said Dr. Otis Brawley of the American Cancer Society in a statement. "We need balanced, truthful information to be made widely available to physicians and patients when making important health decisions."

Nearly 241,000 men will be diagnosed with prostate cancer this year, and 34,000 men will die of the disease.

WebMD has more on prostate cancer.

10 Photos

Prostate Cancer Self-Defense: Nine Deadly Myths

[WalterAdkins]

I would recommend this health insurance plan i found through "************" to anyone with a growing family who is looking to minimize their medical expenses.

[markag55]

All men over 50 should be screened for prostate cancer by their PSA count. It's inexpensive, blood work taken with other blood work, and even though it may not be a perfect indicator of prostate cancer, I have had it done every year since I was 50 (I'm now 58). I don't know the real reason why all of a sudden they're saying that we shouldn't be screened for this type of cancer. Yes, prostate cancer is usually slow-growing and does not metastasize. But does this mean I don't want to know if my PSA might show that this cancer MIGHT exist? No way. Unless they can come up with a better way, I'll stick with this tried and true way. They say that there are too many false positives--great! I'd much rather have a false positive than a false negative. This is ridiculous. I really think it's the insurance companies who don't want to cover this rather cheap procedure. One more reason to go to a government one-care diagnosis and treatment regimen. People should not make a profit from our illnesses or non-illnesses. That's just downright wrong. When it comes to health care, there should be no one making a profit. And while I'm at it, big-pharma should not be reaping the huge profits they make. They should profit if they were the scientists that came up with a new drug; however, most new drugs are funded by the federal government in association with big-pharma.

Remember, we're the 99%--big-pharma and their CEOs are the 1%.

[baileyccc]

Fatesrider must be the Big Pharma representative monitoring all health related remarks.

[baileyccc]

This sounds like Big Pharma talking thru their puppets, the main stream press. Most of western medicine test are so unreliable but the prices are for real. CBS knows how to pleases it's largest advertisers.

[Fatesrider]

So, you think that by recommending people NOT be screened with an ineffective test, this somehow benefits big pharma? The result of this is that a lot of people won't have to pay for expensive confirmation tests or drug treatments they didn't need in the first place. Exactly how does taking away excess, unnecessary business from big pharma HELP them?

I realize thinking isn't something most people are suited to be doing, nor is actual use of logic a factor in most arguments today, but your post makes absolutely no sense.

I think you got your Fox News talking points mixed up again.

[PourpaixPourpaix]

Either the panel is staffed by politicians who care about something other than my health, or it is composed of health care "experts" who are incompetent. (That's a nice way of saying they're corrupt idiots, by the way.)

Half of us guys over 50 have enlarged prostrates, 20 million men. Don't worry about it? 17% of us develop prostrate cancer. If we don't perform tests, how do we determine if it's the slow kind that may never affect us, or the fast kind of prostrate cancer that'll put us in an early grave? Annual tests yield vital information, and what's done about it can differ depending on the circumstances. You don't just stick your head in the sand.

My neighbor has advanced prostrate cancer after ignoring the warning signs for years. Now that he's older (67) and they've found the rate of growth is threatening his health, they say he's too weak to survive the operation or radiation. Prognosis is awful. If they only did something about it years ago when he was healthy enough to undergo treatment.

[Fatesrider]

God, you may be over 50, but you whine like a child who misunderstood the point.

They're talking ROUTINE SCREENING. That doesn't mean the ones you do because you think something's wrong. It's the ones they do on folks who have no symptoms at all - which is done way too often at too high of a cost without necessarily finding anything almost all of the time.

Your friend had SYMPTOMS he ignored for YEARS. That's on HIM. They probably did do a test, and it came back as a false negative and he never mentioned it again. But frankly, I don't want to be tested every year or two for something that MIGHT be wrong with me if I don't have ANY symptoms of that problem. The re3commendation is to stop doing that.

Your friend had symptoms HE ignored for years - which was during the time they were doing the testing. Goes to show that test isn't fool-proof. In fact the story said "it doesn't work". So your friend will probably die, as many men do, because he didn't say anything more about his problem. Ignoring symptoms can kill you just as fast as getting a false positive, having biopsies, radiation and drug treatment you don't need.

[PourpaixPourpaix]

Screw you Fatesrider, if you think there is such a thing as a healthy man over 50. It is you who missed my point. A simple test establishes a baseline for which changes indicate significance. Perhaps you will someday realize the other point, that it's far better to detect and correct a problem early, while one is healthy enough to withstand treatment. Someone with sense will find out, monitor, and make an intelligent decision based on knowledge. But in your case, feel free to stick your head in the sand.

[emag]

jeshuey...

I, too, would be dead or dying had I not received a biopsy as a result of elevated PSA, but this has nothing to do with 'Obamacare' and "death panels". What is being left out of all the reporting on the change in PSA screening recommendation is that men with a strong family history of prostate cancer should STILL be screened with PSA. PSA is no longer recommended for routine screening of men not otherwise at risk. For men reading this, if your father, uncle, brother, or grandfather (paternal) had prostate cancer at a young enough age to be a risk, get a PSA test annually. Prostate is the most curable of internal cancers, but once it leaves the prostate it's horrible.

[jeshuey]

It would be interesting to view the reaction if a panel stated that since only three of every five breast cancer cases detected would ever kill women, so we should stop screening for it.

If this policy had been in effect six or so years ago, I would either be dead or in the process of dying a painful death. For the first time I understand what the opponents of ObamaCare meant by "death panels".