The study findings appear in the March 15 issue of the New England Journal of Medicine.
A physician who wrote an accompanying journal commentary said the new findings "add more confusion" to the issue. But one thing is clear: They don't convince him that routine PSA tests are a good idea.
The problem is that "you can have prostate cancer sitting there, doing nothing," said Dr. Anthony Miller, professor emeritus of epidemiology at the University of Toronto's Dalla Lana School of Public Health. "It's not going to kill them; it's not going to grow."
But a PSA test can still discover prostate cancer, leading to unnecessary tests and treatment.
"You'll always find people who are convinced that no matter what is done, the evidence doesn't matter and what they really want to find out is if they have any cancer," Miller said. "They will assume that the mere fact of finding a cancer will mean that good has been done."
Miller recommends the PSA test only for men who have certain symptoms or if it's used to monitor treatment in men who have prostate cancer. "As a general screening for healthy men, I do not recommend it at all," he said.
Miller also doesn't recommend the prostate examination done by hand that physicians commonly give to middle-aged and older men, unless symptoms are present.
For more about prostate cancer, try the U.S. National Library of Medicine.
SOURCES: Fritz Schroder, M.D., professor of urology, Erasmus University, Rotterdam, Netherlands; Anthony Miller, M.D., professor emeritus of epidemiology, Dalla Lana School of Public Health, University of Toronto. March 15, 2012, New England Journal of Medicine
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