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Experts Back Away From Annual PSA Test
Date:4/27/2009

, such as family history and ethnicity," Carroll said.

Another major change is that the guidelines set no specific PSA blood level as an indicator of danger, he said. The danger level for an individual man will depend on other risk factors.

And yearly PSA tests might not be needed for many men, the guidelines note. "Screening less frequently may be a less costly way to screen," Carroll said. No specific timetable for less frequent screening is set in the guidelines, but they might be recommended as more information becomes available, he said.

The new guidelines did take into account two recent studies, one in Europe which found that regular PSA screening reduced prostate cancer deaths, and one in the United States which found no effect of screening, Carroll said. The U.S. study was flawed in several ways, he noted. For example, it permitted men who were not assigned to the group for screening to go have PSA tests on their own.

"Both studies do not suggest that PSA screening should not be undertaken," Carroll said.

New information on PSA testing has been a major focus at this year's AUA meeting. One study by urologists at the University of Colorado focused on the timing of PSA tests. The study, which followed more than 76,000 men for at least five years, found that the PSA levels of nearly 99 percent of men with very low readings on an initial test would remain low for at least five years. That suggests that limiting tests to every five years for men at that low level, and to every two years for men with slightly higher readings, would lower the overall need for PSA tests by 70 percent, reducing testing costs by $1 billion a year, the researchers reported.

On the other hand, a Swedish study found that PSA readings at age 60 were strong indicators of increased prostate cancer death risk. But "60 -year-old men with PSA at or below 1 nanogram per milliliter [a low reading] can be told that although they harb
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