Should Men Get Prostate Cancer Screening?

March 18, 2009

Should Men Get Prostate Cancer Screening?

By AUDREY GRAYSON
ABC News Medical Unit
March 18, 2009

At 62 years old, Eric Larson is among an age group that many health organizations recommend get annual prostate test to detect signs of prostate cancer.

Should Men Get Prostate Cancer Screening?

Two new studies on the PSA test for prostate cancer may leave many men confused as to whether or not to opt for the screenings.

However, Larson opts out of the screening year after year.

The reason, he said, is that studies have not demonstrated that “there is any benefit [to the prostate specific antigen screening] and there is certainly a good chance the PSA [prostate specific antigen] screening leads to procedures with complications and without benefit.”

And Larson should know — he is a physician who serves as the executive director of the Group Health Center for Health Studies in Seattle Wash.

Like many other doctors, Larson has been waiting for years to see the results of two large trials in the United States and Europe to determine whether the screening for prostate cancer actually saves lives.

Now that the day has come and results are out, many doctors are left with more questions than answers on the benefits of regular prostate specific antigen screenings — and Larson will continue to opt out of his own screenings.

Researchers for a U.S. study came to the conclusion that, after seven to 10 years of follow-up, men who got the PSA test were no less likely to die from prostate cancer than men who did not. A separate European study, on the other hand, suggested a benefit to getting tested — albeit a disappointingly small one.

But perhaps the biggest burden of these inconclusive results lie with men Larson’s age who are not doctors and are ultimately left to decide whether the PSA screenings are worthwhile to them. Worse, a positive result could force these men into an even more grueling decision — what to do if the screening results show elevated prostate specific antigen levels.

Simple Test, Difficult Questions

The drawbacks to the PSA screenings are fairly well understood: Though the test can determine whether a man has prostate cancer, it cannot provide any information on how aggressive or serious the cancer is.

“The challenge we have right now is that when we find prostate cancer, we don’t know whether it’s a killer cancer or what has been termed a ‘toothless lion’ type of cancer — one that a man will die with, not of,” Dr. Gerald Andriole said during National Cancer Institute news conference Tuesday.

“And we’ve made the mistake of tending to treat all of these patients aggressively,” said Andriole, chief of the Division of Urologic Surgery at Washington University in St. Louis, Mo.

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