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PSA Test's Overall Benefit Still Unclear: Study
Date:8/15/2012

By Maureen Salamon
HealthDay Reporter

WEDNESDAY, Aug. 15 (HealthDay News) -- The latest entry in the scientific debate over the value of prostate-specific antigen (PSA) testing suggests its overall worth remains far from clear.

Using statistical modeling, Dutch researchers concluded its benefits are diminished by lost quality of life from serious side effects and the decision whether to screen should be left to men and their doctors.

In their study, the study author predicted that annual PSA tests for men aged 55 to 69 would result in nine fewer prostate cancer deaths (28 percent) for every 1,000 men screened.

But they were also able to quantify harm and survival on the same scale by calculating quality-adjusted life years.

With harms such as impotence and incontinence factored in, "the disadvantages of screening diminish the benefits [of added lifespan] by 20 percent," said study author Eveline Heijnsdijk, a researcher at the department of public health of Erasmus Medical Center in Rotterdam.

"Individuals and clinicians have to decide themselves whether the benefits outweigh the harms," Heijnsdijk said.

The quality-adjusted life year index is a measure that assesses the value of a medical intervention. PSA is a protein in cells of the prostate gland, and the higher a man's PSA the more likely it is he has cancer.

Dr. Louis Potters, chair of radiation medicine at North Shore-LIJ Health System in New Hyde Park, N.Y., agreed the findings suggest a need to consider each case individually.

"Once again, these results confound any definitive conclusion," said Potters. "This particular study further hardens the argument that you do need to think about it, you do need to personalize it and there isn't a one-size-fits-all approach, as disappointing as it might be for each side of the argument."

The study is published Aug. 16 in the New England Journal of Medicine.

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