PSA Screening: Yes or No?

September 24th, 2012  |  The Blog

Should you have the traditional prostate specific screening (PSA) drawn this year or not? This is a recurring question for male patients all over the U.S. It is critical to weigh the benefits against the risk of knowing the number. If cancer treatment is indicated, is the benefit of adding a few years to a man’s life worth the potentially debilitating side effects of the treatment? Herein lies the debate.

The Study

The New England Journal of Medicine recently published the results of a Dutch study, which evaluated the risks and benefits of evaluating a yearly PSA test.

Those male patients, ages 55 to 69 years, who had an annual PSA drawn, experienced a 30 percent lower risk of dying from prostate cancer. That said, the same patient population experienced a reduced quality of life for several reasons:

  • Receiving a cancer diagnosis
  • Undergoing cancer treatment earlier in life, rather than later
  • Suffering potential permanent side effects from prostate cancer treatment including urinary incontinence and/or erectile dysfunction

What do the numbers really mean? For every 1000 male patients who are regularly screened with PSA, there is a net gain of .56 of a year or 7 months added to their life. The result of this Dutch study airs on the theory that the U.S. government’s recent recommendation against regular PSA screening was made in haste. The debate rages on.

The Final Decision

As the studies and debate about an annual PSA continue, it is important that every male patient, 50 to 70 years old, make an informed decision, with critical input from their primary care physician or urologist, about moving forward with the testing. Many publications liken the PSA debate to that of women in their 40s and whether or not to begin getting annual mammograms.

The U.S. Preventive Services Task Force recommends the following across the board:

  • Annual mammogram for women 50 to 74 years old
  • Annual PSA screening for men 50 to 70 years old
  • Testing is not advised for patients over the recommended ages

Overall, most men do realize useful information from PSA testing. The big decisions come when they need to choose a treatment option based upon those results. Educating patients about what those options will be, given the PSA test findings, is a critical component in the decision to move forward with the annual testing or not. A frank and open discussion with the physician is paramount.

 

 

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