Other highlights in the Septemb...( Nearly a third of prostate biopsies ...),Health

Nearly a third of prostate biopsies resulted in a cancer diagnosis among a population of older men on Medicare. Men whose first biopsy did not find cancer often had multiple biopsies in the future, which increased the chance of a cancer diagnosis.

While PSA (prostate-specific antigen) tests have become widely used in prostate cancer screening, a biopsy is what actually determines the presence of prostate cancer. Nonetheless, it remains unclear whether or not PSA screening actually reduces prostate cancer mortality.

H. Gilbert Welch, M.D., of the Department of Veterans Affairs Medical Center in White River Junction, Vt., and colleagues estimated the proportion of prostate biopsies that result in a cancer diagnosis and the likelihood of finding cancer with subsequent biopsies after the first one was negative. The researchers analyzed the outcomes of 10,429 biopsies performed from 1993 to 2001 in 8,273 men aged 65 and older.

About one third of prostate biopsies detected cancer, and the proportion of biopsies that found cancer increased as men got older. Among men whose first biopsy did not show cancer, about one third of them had another biopsy within five years. Nearly half of men who had a second biopsy were diagnosed with cancer, and the chance of diagnosis increased with each subsequent biopsy.

Because the goal of screening is to reduce deaths from the disease and not simply to find more cancer, the utility of [repeated biopsies warrant] careful reassessment, the authors write.

Contact: H. Gilbert Welch, h.gilbert.welch@dartmouth.edu, (802) 296-5178

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