Navigation Links
Panel's Rejection of PSA Test Spurs Mixed Reaction From Experts
Date:10/8/2011

By Steven Reinberg
HealthDay Reporter

FRIDAY, Oct. 7 (HealthDay News) -- News that a key government advisory panel will give a thumbs-down next week to a controversial blood test for prostate cancer is garnering both praise and condemnation from experts.

A draft report due out early next week from the United States Preventive Services Task Force (USPSTF) will recommend that healthy men forego regular prostate-specific antigen (PSA) testing aimed at spotting prostate cancer, the The New York Times and other media outlets reported Friday.

The USPSTF is the same independent group of medical experts that caused a firestorm in late 2009 when they ruled against the use of annual mammographies for average-risk women in their 40s.

The PSA test has been similarly controversial, since its overall benefit in saving mens' lives has been challenged by a number of studies. Among the reasons the USPSTF cited in rejecting the PSA test is that the screen does not save lives and instead can result in unnecessary treatments that can leave men with discomfort, impotence and incontinence.

According to the Times, the task force focused on the results of five trials, the two largest done in Europe and in the United States. The European trial included 182,000 men. Over nine years of follow-up, it found no reduction in deaths due to prostate cancer among men of all ages in the study who were underwent PSA testing. But it did find some reduction in deaths among men aged 55 to 69 who got the blood test.

The American trial, involving almost 77,000 men followed for over a decade, also failed to show an overall reduction in deaths among all the men who were screened.

"Unfortunately, the evidence now shows that this test does not save men's lives," Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force, told the Times. "This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does."

But Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston and a prostate cancer expert, said the task force's recommendation is misguided.

D'Amico noted that in the European study, screening reduced cancer deaths among these younger men by 44 percent. The U.S. study also showed a 44 percent reduction in cancer death among younger men, he added. "If they look at all the screening studies, they will find that the people who benefited most from screening were the youngest and presumably the healthiest," he noted.

"The panel has not really appreciated the entirety of the evidence," D'Amico said. "Considering all of the data, it appears that younger or healthier men benefit from PSA screening."

Right now, most men are advised to undergo regular PSA tests beginning at age 50. However, because most prostate cancers grow very slowly and may never prove fatal, the value of early treatment has come into question.

Of course, some prostate tumors are aggressive and can prove deadly. Most experts acknowledge that the real problem, right now, is that there's no reliable test to tell a patient which type of tumor he might have.

Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, also cautioned that the task force's decision is not yet set in stone.

"It is important to keep in mind that under the new USPSTF process, the recommendation is not final until the conclusion of the public comment period and the USPSTFs review of those comments," he said.

According to Brawley, the cancer society pored over the existing body of evidence in 2009 and at that point it determined that it could not conclude whether or not PSA screening saves lives.

"We have long been concerned, and it has been very apparent for some years, that some supporters of prostate cancer screening have overstated, exaggerated and, in some cases, misled men about the evidence supporting its effectiveness," Brawley said. "We need balanced, truthful information to be made widely available to physicians and patients when making important health decisions. Sadly, that has not happened with this disease."

Brawley believes men must have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after they receive information about the uncertainties, risks and potential benefits associated with testing for early prostate cancer detection.

"The ACS also strongly asserted that prostate cancer screening should not occur without an informed decision-making process," Brawley added.

D'Amico, who supports PSA testing, added that while over-treatment based on PSA test results has been a problem, much of that can be eliminated if the test is based on the most accurate PSA results. To make the test more accurate, men should stay away from sexual activity just prior to the test, bike riding, horseback riding and colonoscopy, he said. In addition, they should not have a PSA test if they have a bladder or prostate infection; and should wait at least a month after it has cleared up.

"Also, once a person is diagnosed it doesn't mean that they have to undergo treatment -- they can have a discussion with their physician about the significance of this cancer," D'Amico said. "Diagnosing allows one to have the opportunity to understand whether this is a cancer that requires treatment or not. But, putting your hands over your eyes saying, 'I don't want to know,' actually can lead to unnecessary death."

"I would still recommend an annual PSA, particularly for men who are healthy and under 65," D'Amico concluded.

Another expert, Dr. Lionel L. Banez, also supports continued use of the test. Banez, an assistant professor in the division of urologic surgery at Duke University Medical Center, said "the draft of the USPSTF review does provide evidence that PSA screening reduces prostate cancer mortality -- albeit not in as great a magnitude to be called optimal."

Prostate cancer remains the second most common cause of cancer death in men after lung cancer, Banez noted. "Thus, a slight reduction in mortality could still translate in a substantial absolute number of lives saved. Though it is clear that we still need to find a better test to improve early detection of significant disease and to curtail over-treatment, it is not advisable to discourage use of a currently existing test that is proven to save lives," he said.

More information

For more on prostate cancer, visit the U.S. National Cancer Institute.

SOURCES: Anthony D'Amico, M.D., Ph.D, chief, radiation oncology, Brigham and Women's Hospital, Boston; Lionel L. Banez, M.D., assistant professor, Division of Urologic Surgery, Duke University Medical Center, Durham, N.C.; Otis W. Brawley, M.D., chief medical officer of the American Cancer Society; Oct. 6, 2011, New York Times


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. All Global Launches Physician Panels in Russia and Poland
2. ANY LAB TEST NOW Launches New Infectious Disease Panels - Affordable Panels Test for H1N1, Staph, E. coli and Other Infectious Diseases
3. FDA Panels to Weigh Dosing Labels for Kids OTC Fever Relievers
4. Astellas Responds to OSI Pharmaceuticals Rejection
5. Gene pattern may identify kidney transplant recipients who dont need life-long anti-rejection drugs
6. Gene pattern may identify kidney transplant recipients who dont need lifelong anti-rejection drugs
7. Study links romantic rejection with reward and addiction centers in the brain
8. Vitamin D deficiency linked to lung transplant rejection
9. UCLA team uncovers mechanism behind organ transplant rejection
10. Gift-Giving, for Many Men, Means Avoiding Rejection
11. Romantic Rejection May Hurt Just Like Physical Pain
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Panel's Rejection of  PSA Test Spurs Mixed Reaction From Experts
(Date:2/8/2016)... ... February 08, 2016 , ... If you are feeling that your ... are not alone. According to the Center for Disease Control and Prevention (CDC), 34.9% ... diabetes and certain types of cancer, some of the leading causes of preventable death. ...
(Date:2/8/2016)... ... February 08, 2016 , ... Steve Helwig & Associates Insurance & ... community enrichment program, has teamed up with Citizens Opposed to Domestic Abuse in support ... abuse. To support all those victimized by the fear of violence in their own ...
(Date:2/8/2016)... ... February 08, 2016 , ... ... serving the greater Venice, FL area, has initiated a fundraiser for a two ... accident just four days after Christmas. To support this beautiful child who is ...
(Date:2/8/2016)... ... February 08, 2016 , ... ... firm, announced today that nominations will be accepted February 8, 2016 through ... , Awards include the Information Security Executive® of the Year, which ...
(Date:2/8/2016)... ... February 08, 2016 , ... Eating disorders and post-traumatic stress ... women and men with eating disorders report a history of trauma, research suggests ... of an eating disorder. , At the 2016 iaedp Symposium, the workshop, ...
Breaking Medicine News(10 mins):
(Date:2/8/2016)... BioPharma Corp. (CTI BioPharma) (NASDAQ and MTA:CTIC) today announced ... Food and Drug Administration (FDA) on February 4, 2016, ... on the clinical studies being conducted under the Company,s ... hold impacts part of the clinical work currently being ... clinical trials. --> ...
(Date:2/5/2016)... 2016  Despite the recent explosion in Big Data, ... to embrace Big Data due to the inherent costs ... side, organizations have begun looking to Big Data as ... adherence. --> --> ... LLC, Big Data has started informing many decisions. In ...
(Date:2/5/2016)... -- Redwood Scientific Technologies, Inc. announced today the development and ... balance their hormones. This product will be featuring Redwood,s ... Cardiff , President and CEO. "I am proud that ... of women across the country and around the world ... research and development team is confident that through the ...
Breaking Medicine Technology: