The prostate-specific antigen (PSA) test is widely used to
check for prostate cancer. However the test has some limitations; for example,
UCLA Health System notes that the test “may be high” in men with prostate
cancer, although it also can be in men with a noncancerous enlargement of the
prostate.
On October 7, the U.S. Preventive Services Task Force announced that
it is poised to recommend that healthy men should not be screened with a PSA
test. A person familiar with the draft document told the Wall Street Journal
that the panel will recommend a "D" rating for the test. A
"D" rating indicates that "there is moderate or high certainty
that the service has no net benefit or that the harms outweigh the
benefits." It also is a recommendation to "discourage use" of
test or treatment. The task force is expected to make its proposal on October
11 and then allow for a four-week comment period before issuing a final
recommendation.
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Virginia A. Moyer, who chairs the task force, declined to
comment on the updated advisory. She noted that the current guidance is that
the evidence is insufficient to recommend for or against screening in men
younger than 75. That recommendation was last updated in August 2008. Dr. Moyer
noted, “New evidence has become available, and we had to reconsider our
statement.” The new report marks the latest in a long-running controversy over
the value of PSA screening.
Proponents of the test point out that when it is
conducted regularly on men age 50 and over, it increases the chance of
discovering the cancer at an early stage; thus, improving the chances of
successful treatment. Opponents counter that the test has a significant rate of
false positives (an elevated value, which does not indicate a cancer) or that
it identifies so-called indolent tumors, which have minimal impact on one’s
health. The false positives result in unnecessary biopsies and cancer
treatments. Furthermore, in some cases, these unnecessary treatments can lead
to infection, impotence, and/or incontinence.
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