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

A key government panel has raised concerns about the reliability of the P.S.A. blood test, which is used to diagnose prostate cancer. Dr. Jon LaPook reports the test is not nearly as helpful as previously thought.

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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.

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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.


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