Screening for prostate cancer could help men who are otherwise healthy, despite uncertainty over the usefulness of the tests for younger men.
Routine screening for prostate-specific antigen, believed to indicate a tumor, begins at age 50. But federal health officials have questioned whether the screens — at $50 or more apiece — do more harm than good.
That’s because prostate tumors are generally slow-growing, meaning that some men may undergo unnecessary radiation treatment or even surgery to remove their prostates. Side effects from the procedures can include erectile dysfunction and urinary incontinence.
Federal health officials say routine PSA screening for men between 50 and 75 may not be necessary and recommend that men over age 75 forego the tests entirely.
Now researchers in Boston have re-examined data from an earlier study showing no difference in death rates in 70,000 men who either had annual tests or normal care. Their research showed that prostate cancer killed two men in 1,000 over a decade. The routine screening didn’t help men with other conditions, like heart disease or other cancers, but for otherwise healthy men the PSA test cut the rate of cancer death in half.
“The reason why the original study appeared to be negative is it looked at all patients,” Dr. Anthony D’Amico, an oncologist at Brigham and Women’s Hospital in Boston, told Reuters Health. “What this study suggests is that PSA tests could be used more selectively in men who are in good health.” he told Reuters Health. “For men who aren’t as healthy, it suggests that screening may not make a difference.”
That’s because an unhealthy 60-year-old might die of other causes before benefitting from removing a cancerous prostate, D’Amico said.
Dr. Ned Calonge, who heads the U.S. Preventive Services Task Force, cautioned that analyses based on earlier data could often lead to “exaggerated or mistaken conclusions.”
Noting that the less-healthy men who were screened seemed to run more risk of dying from prostate cancer than the control group — a finding that is hard to explain — Calonge said the new study should fuel further research into the utility of the screening.
“This does not trump the results of the original study, but provides an interesting finding that may prompt additional research on this issue,” Calonge wrote in an email to the news service.
