PSA guidelines for men being widely ignored

The Los Angeles Times “Booster Shots” blog reports, “Guidelines limiting PSA screening for prostate cancer detection in older men are widely ignored,” according to a research letter published in the Journal of the American Medical Association, “and physicians seem likely to continue to ignore them.”

The ABC News “Medical Unit” blog reports, “In 2008, the USPSTF [US Preventive Services Task Force] issued a recommendation that found limited benefit for screening men ages 75 and older for prostate cancer.”

Just “last year, the task force drafted guidelines that said prostate screening was of limited benefit for helping men of any age live longer, and that harms of unnecessary treatments often outweigh benefits.”

The Huffington Post reports, “Relying on data from the 2005 and 2010 National Health Interview Surveys,” researchers “studied how patient practice was influenced by 2008 guidelines from the US Preventive Services Task Force that recommended against PSA screening in men 75 and older.”

The investigators “found virtually no change: 43 percent of men aged 75 and older underwent screening in 2005, versus 43.9 percent in 2010.”

The Boston Globe “Daily Dose” blog reports, “In fact, PSA screening in men over 75 was more common than in men in their 50s; men ages 60 to 74 had the highest screening rates: 51 percent.”

The New York Times “Well” blog reports, however, that “not every medical group opposes PSA testing of older men.”

For instance, “the American Cancer Society and the American Urological Association discourage screening for men whose life expectancy is 10 years or less, but suggest that a man who is expected to live 10 years or longer discuss the risks and benefits of testing with his” physician.

Meanwhile, MedPage Today reports that in a separate study published “in Archives of Neurology, researchers led by Craig Pollack, MD, of Johns Hopkins University School of Medicine in Baltimore, found that, in a diverse sample of doctors, the current recommendation was unlikely to change their practice markedly.”

The researchers found that “more than 90% of the respondents said they were aware of the task force draft recommendations … and 49.2% agreed or strongly agreed that the recommendations were appropriate, while 36% disagreed or strongly disagreed.”

But, when “asked how they thought the recommendation would change their practice,” nearly 38% “said that they would not change how they order PSA screening.”

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3 Responses to PSA guidelines for men being widely ignored

  1. Tommy Dietz says:

    Dear Dr. Walt,

    My PSA is 1.0, and I plan to continue annual PSA tests.

    Tommy Dietz

  2. Arthur Freeland says:

    Walt,
    The “not change their current practice” may not be a bad thing. Those of us who have kept track of the evidence over the years have never pushed screening in the elderly and have let men from 50 to 70 make their own decision. That statistic from autopsy data of 80 year old men having an 80% incidence of prostate cancer was pretty compelling for me. So I will not “change my practice” but I was already following the guideline as it was, even before 2008.

  3. Dr. Walt says:

    Art, good point, and congrats to you! However, there’s a vast potential difference between “already following” and “ignoring” the guidelines.

    Walt

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