When it comes to middle age, routine prostate cancer screening tests are to men what mammograms are to women. However, a federal task force believes administering the prostate-specific antigen (PSA) test on a routine basis to healthy middle-aged men is a waste of time.
According to the U.S. Preventive Services Task Force (USPSTF), the PSA test might cause more harm than good. The task force is an independent group authorized by Congress in 1984 and supported by the U.S. Department of Human Services. Its 16 volunteer members represent various medical fields. Its job: improving the health of Americans by making recommendations about clinical preventive services like screenings, medications, and counseling.
The task force says that prostate cancer is the most frequently diagnosed non-skin cancer in U.S. men. The lifetime risk of a diagnosis is an estimated 15.9 percent. The likelihood of actually dying of this type of cancer is less than 3 percent, and the disease is rare before age 50. Around 70 percent of the deaths attributed to it occur in men older than 75.
The USPSTF findings suggest that routine PSA testing would help save the life of just one man out of 1,000. According to the Washington Post, the recommendation concludes that for every patient saved by a PSA test, one will develop a serious blood clot, and two will experience heart attacks. Another 40 will experience impotence or incontinence after unnecessary treatment. However, patients with urinary symptoms such as pain or trouble urinating might benefit from the screening, the USPSTF concluded. Urologists expressed a very negative reaction to the recommendations.
A PSA test doesn't actually detect cancer. It finds a protein manufactured by the prostate. A number of benign prostate problems can cause elevated numbers of protein. This might mean a false positive leading to biopsies and other testing.
Most doctors don't rely solely on a PSA test when a patient has symptoms that might point to prostate cancer. A man who has reached his forties might also experience a digital rectal exam, ultrasound, and/or a transrectal biopsy of the prostate, says the Mayo Clinic.
Results of a PSA test with elevated numbers struck home last year. A family member with a history of low numbers went in for another routine screening. The PSA numbers had increased significantly but were still within normal range. Told to return in six months, he showed up, non-symptomatic, for the second blood test on schedule. The numbers were a bit higher but still within normal range.
Two weeks later, he underwent outpatient biopsies. He likened the procedure to a dozen cookie cutters powered by a pneumatic drill. He bled for days and experienced pain for weeks. There was no cancer. He has no plans to undergo additional routine prostate cancer screening.
Vonda J. Sines has published thousands of print and online articles. She specializes in health and medical topics, with a particular interest in diseases and other conditions that affect quality of life.
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