Health experts: Routine PSA tests for prostate cancer not good for health

P.S.A. blood test reliability in question
Dr. Michael Lefevre was on the U.S. Preventive Services Task Force that recommended that PSA tests may be more harmful than helpful.

(CBS News) A top panel of health experts called the U.S. Preventive Services Task Force says that men should no longer get routine prostate-specific antigen (PSA) tests to screen for prostate cancer. The reason, it says, is that the tests may lead to treatments that do more harm than good.

U.S. panel recommends against PSA tests for screening prostate cancer in men of all ages

More than 33,000 American men die of prostate cancer each year. And, every year, 20 million get the PSA test to detect the disease early. The recommendation is already causing a lot of criticism. Dr. Jon LaPook reported on the issue.

For 20 years, the message has been the same: Get a PSA test every year or two, detect prostate cancer early -- and save your life. Dr. Michael Lefevre helped lead the panel that said the message was wrong.

"The problem is that in contrast to the small benefits, a significant number of men will be harmed by the test and treatments that follow prostate cancer screening," he said to CBS News.

The task force said:

  • The PSA is unreliable, giving a falsely positive result 80 percent of the time.
  • Prostate cancer is typically diagnosed in older men, and the disease usually progresses so slowly they die of something else.

The panel is among the most influential in the country. It cited an 11-year study of over 180,000 men. The study showed more than 1,000 need to be screened to detect 37 cancers and prevent a single prostate cancer death.

The options for men with prostate cancer include radiation, surgery, hormones and or simply observing. Side-effects of treatments include erectile dysfunction and urinary difficulties. Lefevre says the consequences can be even worse.

"Ultimately, we'll find that two to three men out of those 1,000 will, in fact, have a serious complication such as heart attack, stroke, blood clot or even death," Lefevre said.

The recommendation sparked fury today at the annual meeting of the American Urological Association. In a statement, the group said it was "outraged" and that the recommendation was "inappropriate and irresponsible."

"I do not believe that the medical evidence in any way supports this conclusion," Dr. Herbert Lepor, the head of urology at NYU Langone Medical Center, told CBS News.

"PSA has taken us down the road to decreasing the risk of prostate cancer deaths," he said. "We all recognize we've got a long way to go to perfect screening, but the last thing we need to do is turn back."

"We have been taught for years to fear cancer and that only hope is early detection and treatment," Lefevre said. "And so for both doctors and patients alike, it's difficult to accept that some cancers don't need to be discovered and don't need to be treated."

As for those who have a family history of prostate cancer, the panel believes that doctors can't specifically reccommend to do the test -- because it still isn't at the point where it can provide more benefits at the risk of negative consequences. But the test may be further developed, and LaPook suggested that each patient should talk to their doctor about the pros and cons of taking the PSA test.

  • Jon Lapook
    Jonathan LaPook

    Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News. Follow him on Twitter at @DrLaPook