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New Guidelines Rule Out Prostate Screening for Men Over 75
Date:8/4/2008

ke an informed choice at this time," LeFevre said of screening tests. "The current evidence is not enough for us to know the balance between benefit and harm."

Current data show that a third of the men over 75 in the United States receive PSA tests, the task force report said.

A man should talk to the physician about prostate cancer screening, LeFevre said. "That discussion should occur before screening occurs and should include what the test does and does not mean, the consequences of finding cancer, and the uncertainty about whether benefit exceeds harm, based on current evidence," LeFevre said.

Medical organization make varying recommends about prostate cancer screening. The American Cancer Society position is that a test should be offered yearly to men with a life expectancy of at least 10 years, starting at age 50. Men at higher risk, such as those who have one close relative with the cancer, should begin testing at age 45, and those with several affected close relatives can have a first test at age 40, the society says.

The new guidelines "will not sit well with oncologists and a lot of people," said Dr. Susan F. Slovin, an associate attending physician who specializes in prostate cancer at Memorial Sloan-Kettering Cancer Center in New York.

"As medical oncologists, we are always trying to be one step ahead of the cancer," Slovin said. "We are trying to intervene earlier and identify patients who are at risk. We always want to intercede, to do something."

Many older men will still want prostate cancer screening, Slovin added. "These patients are very informed, and their view will be at odds with the recommendations," she said. "These are not the 75-year-olds of 50 years ago. These are physically younger people, still actively functioning sexually in many cases."

Slovin sees the screening pendulum swinging in a direction opposite to that of the new recommendation. "We are starting to make rec
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