Navigation Links
Study Questions Value of PSA Test for Older Men
Date:4/15/2013

MONDAY, April 15 (HealthDay News) -- Only one-third of men over age 65 who receive an abnormal result from their PSA test actually undergo prostate biopsy to look for disease, a new study finds.

Prostate-specific antigen (PSA) screening is a common test that measures the level of a key marker for prostate cancer in the blood. In general, the higher the level of this protein, the more likely it is that a man has prostate cancer, according to the U.S. National Cancer Institute.

The value of the PSA test has recently come into question, however, with several studies suggesting it causes men more harm than good -- spotting too many slow-growing tumors that, especially in older patients, may never lead to serious illness or death.

The new study focused on this issue once again, tracking outcomes for nearly 300,000 men, aged 65 and older, who underwent PSA screening in the U.S. Veterans Affairs health care system in 2003. The men's health was followed for up to five years.

There were more than 25,000 men with clinically abnormal PSA levels. According to the study authors, during the five-year follow-up period, only 33 percent of those men underwent at least one prostate biopsy to check for evidence of cancer. About 63 percent of those who did have a biopsy were diagnosed with prostate cancer, of whom 82 percent were treated for their cancer.

The older the man, the less likely he was to have a prostate biopsy after having an abnormal PSA screening test result. Men with other health problems were also less likely to undergo a prostate biopsy, the investigators reported.

The study was published online April 15 in the journal JAMA Internal Medicine.

Among men with biopsy-detected prostate cancer, the risk of death from causes other than prostate cancer increased with age and with the presence of other health problems, Dr. Louise Walter, of San Francisco Veterans Affairs Medical Center, and colleagues pointed out in a journal news release.

Two experts not connected to the study said the findings weren't surprising, given the patients' ages.

"PSA screening has been controversial as it has a relatively low yield for finding clinically significant cancer as well as potential complications and expense related to diagnosis and treatment," said Dr. Louis Kavoussi, chairman of urology at North Shore-LIJ's Arthur Institute for Urology in New Hyde Park, N.Y.

In the new study, "as age and other chronic illnesses of aging increased, the less likely biopsy was performed," he said. "This makes sense as the authors report that older individuals and those with [other illnesses] are more likely to die of a non-prostate cancer-related cause."

Therefore, the decision to test for PSA levels in older men must take into account their relatively low risk of dying of prostate cancer, Kavoussi said. "Overall, it is known that about 10 percent of individuals diagnosed with prostate cancer succumb to the disease," he said. "In this older patient population study it was 2.2 percent -- much lower, but not zero."

Another expert agreed, saying that younger men may benefit most from regular PSA screening.

"For screening to be effective, we need to focus on men with a long life expectancy," said Dr. Stacy Loeb, assistant professor in the department of population health at NYU Langone Medical Center, New York City. "Screening allows us to diagnose the life-threatening cancers in time for cure [but] diagnosis does not mandate treatment," she explained.

"Once a diagnosis is made, many patients with low risk disease can be safely monitored conservatively," Loeb said. "Men should be actively involved in all of these choices, with a discussion about risks and benefits."

What's really needed, according to Kavoussi, is a screen that can tell a patient whether his prostate cancer is aggressive or not.

There's a "need for better ways of detecting clinically significant disease in this older population, both to avoid overtreatment and to minimize the risk of missing significant disease," Kavoussi said.

More information

The U.S. National Cancer Institute has more about prostate cancer screening.

-- Robert Preidt

SOURCES: Louis Kavoussi, M.D., chairman, urology, North Shore-LIJ's Arthur Smith Institute for Urology, New Hyde Park, N.Y.; Stacy Loeb, M.D., assistant professor, departments of population health and urology, NYU Langone Medical Center, New York City; JAMA Internal Medicine, news release, April 15, 2013


'/>"/>
Copyright©2012 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Study Suggests Vaccine May Help Kids With Brain Cancer
2. Study reveals how cancer drug causes diabetic-like state
3. Coffee Drinking in Pregnancy Wont Lead to Sleepless Baby: Study
4. Lower GI problems plague many with rheumatoid arthritis, Mayo Clinic study finds
5. Veggies Like Broccoli, Cabbage May Help Fight Breast Cancer: Study
6. No Added Cancer Risk From Hip Replacement Materials: Study
7. Reported Decline in U.S. Pneumonia Deaths May Be False: Study
8. Early Study Finds Some Promise for Lung Cancer Vaccine
9. Narcissists Often Ace Job Interviews, Study Finds
10. Sexual objectification of female artists in music videos exists regardless of race, MU study finds
11. Soy may alleviate hot flashes in menopause, large-scale study finds
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Study Questions Value of PSA Test for Older Men
(Date:4/29/2016)... ... April 30, 2016 , ... Mercy College is expanding its Graduate ... programs will be expanding due to high demand: Master of Business Administration (MBA), Master ... this summer. , School of Business Graduate Program Chair Dr. Ray Manganelli ...
(Date:4/29/2016)... ... April 29, 2016 , ... ... Council for Graduate Medical Education (ACGME) that it has received accreditation for its ... accreditation of three residency programs that Memorial is currently pursuing, including Pediatrics and ...
(Date:4/29/2016)... ... April 29, 2016 , ... On Tuesday, April 26, ... the Southeast, celebrated the signature of Gov. Nathan Deal on SB 258, the “Rural ... (R - Cumming), offers a 70% tax credit to individuals and corporations which donate ...
(Date:4/29/2016)... ... April 29, 2016 , ... The White House ... their loans, more information about their loan terms and accounts, and more protections ... debt, including federal and private loans, has reached $1.3 trillion, with 43 million ...
(Date:4/29/2016)... , ... April 29, 2016 , ... ... reveals that infants born with severe congenital diaphragmatic hernia have better survival rates ... with congenital diaphragmatic hernia (CDH)—a condition where the diaphragm fails to form completely, ...
Breaking Medicine News(10 mins):
(Date:4/28/2016)... , April 28, 2016   Acsis , a ... that leading IT market research and advisory firm IDC ... the IDC MarketScape: Worldwide Pharmaceutical Track and Trace Software ... report provides an assessment of the capabilities and business ... trace software market. Logo - http://photos.prnewswire.com/prnh/20160427/360791LOGO ...
(Date:4/27/2016)... Inc. (Nasdaq: HOLX ) announced today ... quarter ended March 26, 2016.  GAAP diluted earnings ... non-GAAP diluted EPS of $0.47 increased 14.6%.  Revenue ... basis, and 6.3% on a constant currency basis.  ... highlighted by 14.6% growth in non-GAAP EPS," said ...
(Date:4/27/2016)... 27, 2016 Elekta today announced ... will be the focal point of seven scientific presentations ... Society for Radiotherapy & Oncology, taking place April 29 ... state-of-the-art radiotherapy system and a high-field MRI scanner with ... the patient,s anatomy in real time. The MR-linac is ...
Breaking Medicine Technology: