Prostate antigen screening : lack of evidence in older men
13 December 2002
The case against prostate specific antigen (PSA) screening for prostate cancer has been strengthened, with a US task force claiming there is insufficient evidence that such screening prolongs life.
(PSA screening involves a blood test to find out the level of prostate specific antigen in a man's blood. Doctor's use this test to help diagnose prostate cancer.)
PSA and digital rectal examination (examination performed by a doctor which involves feeling the size and shape of the prostate via the rectum using a gloved finger) could detect early stage prostate cancer, US Preventive Services Task Force representatives said after an extensive review.
But it remained uncertain whether early detection of prostate cancer prolonged life, they said (Annals of Internal Medicine 2002; 137: 915-16).
Screening for prostate cancer was associated with frequent false-positive results (incorrect positive results) and unnecessary anxiety, biopsies and potential complications of treatment, in some cases of cancer that may never have affected a person's health, the researchers said.
Men aged between 50 and 70 years, or younger men at high risk of prostate cancer, were most likely to benefit from screening.
But older men and men with other significant medical problems were unlikely to benefit.
Between 10 and 20 per cent of prostate cancer was missed with PSA testing alone, and annual screening had no advantage over screening every second year, the researchers said.
Last Reviewed: 12 December 2002
- 1. Medical Observer Weekly 13/12/02
