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PSA Screening for Prostate Cancer Dips in Large U.S. Health Network
Date:2/24/2011

THURSDAY, Feb. 24 (HealthDay News) -- Fewer men at a large U.S. health-care network are undergoing prostate-specific antigen (PSA) screening for prostate cancer since the release of guidelines in 2008 and the publication of two large studies a few years ago, say researchers.

This study examined the U.S. Veterans Health Administration Pacific Northwest Network, where the decline in PSA screening was three percent among men aged 40 to 54, 2.7 percent among men aged 55 to 74, and 2.2 percent among men aged 75 and older.

The 2008 guidelines recommended against PSA screening after age 75 and noted that there was inadequate evidence for or against its benefits for men under age 75.

The agency behind the guidelines -- the U.S. Preventive Services Task Force -- also reported there was "convincing evidence" that PSA screening had resulted in considerable treatment-related harm, including erectile dysfunction, bowel dysfunction, incontinence and death, among men treated for prostate cancer who were very unlikely to have died from the disease.

And of the two large, widely publicized screening trials in 2009, one found that aggressive PSA screening didn't reduce survival among men with prostate cancer, while the other concluded that PSA screening reduced prostate cancer deaths by a modest 20 percent.

The guidelines and study findings may have had a slight effect on PSA screening in the health network, concluded Steven B. Zeliadt, of the VA Puget Sound Health Care System in Seattle, and colleagues.

The latest study appears online Feb. 24 in the Journal of the National Cancer Institute.

"When faced with data that could be interpreted as neither strongly supportive nor decidedly unfavorable, it is natural that health-care providers and their patients might not substantially alter their practices in regard to PSA screening," Siu-Long Yao and Grace Lu-Yao, of the Cancer Institute of New Jersey, wrote in
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