The investigators noted that the data was gathered in the early era of PSA testing. Current practice -- repeated PSA testing using a lower threshold for biopsy, doing more biopsies more frequently and systematically upgrading tumors to increase the detection of "indolent" cancers -- increases the likelihood of overdiagnosis and treatment, Wilt explained.
According to the U.S. National Cancer Institute, there will be about 241,740 new cases of prostate cancer in the United States this year.
In May, the U.S. Preventive Services Task Force recommended against PSA-based screening for prostate cancer. The task force said there is a very small benefit to the test and significant harms.
But other expert groups, most recently the American Society of Clinical Oncology, continue to recommend the tests, at least for those with a life expectancy of 10 years or more.
Dr. Durado Brooks, director of prostate and colorectal cancers at the American Cancer Society, said the latest study will be helpful to those facing a diagnosis of cancer and for the doctors who treat them.
Yet, when faced with a diagnosis of prostate cancer, the vast majority of men choose to do something very quickly, Brooks noted.
"This is partly because we haven't had any good long-term studies, but it's difficult to get past the fear of the word 'cancer,'" he explained. "The study shows the value in taking a step back and looking harder at watchful waiting or active surveillance."
To learn more about prostate cancer, go to the U.S. National Cancer Institute.
SOURCES: Timothy J. Wilt, M.D., professor, medicine, Minneapolis VA Center for Chronic Disease Outcomes Research at the Minneapolis Veterans Affairs (VA) Health Care System; Durado Brooks, M.D.
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