The PSA Test Is Dead!

by ProfKeith

It’s no longer officially scientific to recommend a PSA test “just to see”. A U.S. Preventive Services Task Force is preparing to recommend that the PSA test get a “D” rating, meaning the results are unreliable and likely to lead to unnecessary biopsies, in which the risks outweigh any measurable benefit.

The PSA test results in “small or no reduction” in prostate cancer deaths. So what’s the point?

Of course those who have a personal point of view are not much interested in the scientific reality. A spokesman for the Prostate Cancer Foundation, Dan Zenka, was reported by CNN as describing the proposed recommendation as “a tremendous mistake. You’re talking to someone whose life was saved by [the PSA test].”

But Dr. Kenneth Lin, senior author of the new paper, said he believes PSA testing does more harm than good. “Maybe you should get tested if you have this horrible family history where everyone gets prostate cancer before the age of 50. But for most men, testing is harmful,” he said.

Prostate cancer is the most common type of cancer found in American men, other than skin cancer. It’s the second leading cause of cancer death in men, behind only lung cancer.

See the U.S. Preventive Services Task Force website:

http://www.uspreventiveservicestaskforce.org/

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{ 7 comments }

JOHN ELIAS October 29, 2011 at 5:16 pm

Perhaps it is the interpretation of the PSA readings that is critical

mine had jumped from 5.6 to 7.2 in less than a year at the age of 59

3 Consultants in the UK were not alarmed and told me not to worry

My Urologist in South Africa however was more experienced and discovered a tumour and saved my life

Joe Dagati October 29, 2011 at 5:30 pm

So tell me how do you follow someone cancer who has already been diagnosed. I had surgery in 2004. PSA started rising in 2007 indicating a return of the disease. How would I have know??????????????

ProfKeith October 29, 2011 at 10:10 pm

Can’t comment for you or John Elias. I don’t know what else was done.
Most prostate cancers come to light through symptoms, not this test.
I imagine it will continue to be done for people who clearly have a problem. Just not a good screening tool, that’s all.

Susan Murphy October 30, 2011 at 2:12 am

My uncle at age 41 was saved by this test. His biopsie was positive for cancer. It was caught in time to save his life.

I tried to sign up for your e-mails but my e-mail address (2) were not accepted.

terrence October 31, 2011 at 2:06 am

I have read many doctors who say that all men get Prostrate Cancer; but the vast majority die of other causes. It is one of the slowest growing cancer known.

ProfKeith October 31, 2011 at 4:31 pm

Not true that all get it. But it’s common and slow, as you say.
But once it breaks out (Stage IV) is as deadly as any other.
Prof.

Richard Guenette November 11, 2011 at 3:04 am

There’s enough data and facts in the medical world to advise the patient of what his next steps are when a PSA monitoring or screening is conducted. When the numbers indicate something out of the “norm” for that age group and when a biopsy then shows signs of cancer when all other tests (DRE) do not, isn’t it conclusive that PSA screening is a blessing? If an abnormality is felt or found during a DRE, then the cancer is farther along than it needed to be. The earlier you can catch it, the better decisions you can make. At 54, I had a radical prostatectomy and then after it was analyzed, cancer showed 1 step higher in the grading system from the biopsy. Again, general rule of thumb and true in my case. I can not understand how the medical community can recommend to not conduct PSA testing. I started at 50 with one PSA test then when something indicated an abnormal trend, another PSA was done for further analysis. Free PSA needs to be done along with Total PSA when a Dr starts “suspecting” an abnormal trend.
I can’t urge men enough about the need to be screened early. It at least gives your Dr a referrence so when something does occur, comparisons can be made and a history has been documented.

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