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Routine PSA Tests Discouraged

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The United States Preventive Services Task Force has officially recommended against the routine use of the PSA test to screen for prostate cancer. PSA, which stands for prostate specific antigen is a blood test. As the number rises the likelihood of an enlarged prostate or a tumor increases. The problem is that the PSA test is a poor predictor of dangerous prostate cancer. A large study of 180,000 men lasted 11 years. It found that, at best, one death from prostate cancer might be prevented by screening 1,000 men. Screening itself has some risks, because it can lead to biopsies and surgery. Erectile dysfunction and incontinence are not uncommon complications of surgery.

The American Urological Association is outraged. Many urologists believe that the PSA remains the best way to detect prostate cancer early. The task force concludes that doctors should be ready to discuss the benefits and risks of PSA tests and take patients' preferences into account before routinely adding the PSA to a standard blood panel.

[Annals of Internal Medicine, online May 22, 2012]

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3 Comments

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If your doctor is going to draw blood anyway why not also have the PSA test done?

PEOPLE'S PHARMACY RESPONSE: That would make sense for a man who had symptoms of prostate problems or one who had a family history of prostate cancer. For healthy guys, it's a bit more like troubling trouble.

PSA screening has eliminated advanced prostate cancer for the most part. However, according to Dr Welch in August JNCI, one million men were over-diagnosed and over-treated for prostate cancer over the last twenty years.

Was PSA Screening for Prostate Cancer a 20 year failed Medical Experiment ?


jeffrey dach md

PSA Velocity, or the rate of rise of PSA, has been shown to be a useful indicator of aggressive PCa. However, to take advantage of this, you need a history of PSA levels. In order to have a history, you have to measure PSA periodically over time in asymptomatic, younger men. PSA Screening is in itself not a failed medical experiment, but what has been done with the results is.

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