PSA testing has come under fire in recent years due to alleged overdiagnosis of prostate cancer cases, and a new recommendation from the U.S. Preventative Services Task Force (USPSTF) may raise even more questions about the screening. The task force downgraded PSA screenings from an "I"--inconclusive benefits--to a "D" grade, or no benefit for men under the age of 75. Many cancer organizations have not commented on the recommendation, and others, like the American Society of Clinical Oncology, have noted the need for more research.
After studying 5 clinical trials using prostate specific antigen testing, USPSTF concluded that the test provided no real survival benefit in the U.S., no survival benefit in Europe and could cause unnecessary treatment. Only one Swedish center in the 5 worldwide clinical trials showed a major benefit from PSA screening.
But PSA backers have slammed the recommendation, citing the 40% reduction in prostate cancer deaths since PSA testing became regularly used. "When interpreted appropriately, the PSA test provides important information in the diagnosis, pre-treatment staging or risk assessment and monitoring of prostate cancer patients," said Dr. Sushil S. Lacy, president of the American Urological Association, in a statement. "Until there is a better widespread test for this potentially devastating disease, the USPSTF--by disparaging the test--is doing a great disservice to the men worldwide who may benefit from the PSA test."
Dr. H. Ballentine Carter, director of adult urology at the Brady Urological Institute at Johns Hopkins University, told Renal & Urology News that long-term PSA testing is more effective at diagnosing prostate cancer than analyzing one sample. "Doctors can get a lot more information if there is a PSA history, which is why I believe getting a baseline PSA at a younger age is a reasonable thing to do."
- read the Medpage Today article
- see the piece from Renal & Urology News
ALSO: Researchers at the University of Michigan have developed a urine test to diagnose prostate cancer. The test measures two biomarkers, one that occurs in 50% of prostate cancer patients, and another that is seen in 95% of cases. Release