ROUTINE screening for prostate cancer does not help save the lives of healthy men and often triggers the need for more tests and treatments, a US government health panel said on Friday.
The US Preventive Services Task Force's draft recommendations, which will be open to public comment on Tuesday, are likely to face a pushback from advocates of the PSA blood test as well as from drugmakers and doctors who benefit from the now-lucrative screening industry.
Based on the results of five clinical trials, the recommendation to avoid a prostate-specific antigen test which measures the level of the protein in the blood applies to healthy men of all ages without suspicious symptoms. But it could have an especially dramatic impact on care for men aged 50 and older, who are routinely administered the PSA test.
"The principal risk is overdiagnosis and overtreatment. Most of the cancers that we detect are not cancers that would have ever gone on to cause a man harm in his lifetime," panel co-chair Mike LeFevre told AFP.
The task force also found no evidence that other forms of screening, such as an ultrasound or digital rectal exam or ultrasound, are effective. It did not examine whether testing was beneficial to men who have already been treated for the disease.
Ana Fadich of the Men's Health Network called the recommendations "puzzling," and pointed to evidence that prostate cancer deaths have dropped thanks to screening and awareness.
LeFevre stressed that the panel was not recommending foregoing prostate cancer detection completely and instead suggested that those with symptoms consistent with especially aggressive prostate cancer should get diagnostic testing.
"The most important research that needs to be done is to define characteristics of cancers in order to differentiate the cancers that need to be treated from those that don't need to be treated," he said.
One million men who received the PSA test and would otherwise not have been treated got surgery, radiation therapy or a combination of both between 1986 and 2005, according to the task force.
It pointed to evidence suggesting that up to five in 1,000 men will die within a month of prostate cancer surgery and between 10 and 70 in 1,000 men will suffer from serious complications.
"Radiotherapy and surgery result in adverse effects," the task force added, noting that 200 to 300 in 1,000 men treated with such therapies have urinary incontinence or impotence. An estimated 217,730 men in the United States were diagnosed with prostate cancer and 32,050 died last year from the disease.
AFP
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