PSA recommendation has led to decline in early prostate cancer rates

Reuters reports that research suggests that a 2008 US Preventive Services Task Force (USPSTF) recommendation discouraging prostate cancer testing in older men has led to a decline in the rate of early-stage prostate cancer in this group.

MedPage Today reports, “After the release of the US Preventive Services Task Force recommendation four years ago, the rate of stage T1 or T2 prostate cancer among older men fell by 25.4% (P<0.001), according to David H. Howard, PhD, of Emory University in Atlanta.”

Additionally, “there…was a 14.3% decline in stages T3 and T4 cancers (P<0.001) and a 16.8% decrease in tumors of unknown stage (P<0.001), Howard reported online in a research letter in Archives of Internal Medicine.”

The Boston Globe reports, “It’s been two months since a government task force recommended against doctors routinely ordering prostate cancer screening tests.” However, “many physicians disagree with the new guidelines, leaving men in a quandary: Should they continue to be screened with a prostate-specific antigen (PSA) blood test and digital rectal exam beginning at age 50, or should they skip the screening altogether?”

The Globe points out, “For every 100 men who get a PSA test, three will have real cancers detected and two will have cancers that are missed, according to the American Society of Clinical Oncology.”

The New York Times “Well” blog reports on a recent study published in the New England Journal of Medicine in which “731 men with early-stage prostate cancer…agreed to be randomly assigned to surgery or a program of watchful waiting.” Investigators found “no statistical difference in the prostate cancer mortality rate or the overall death rate between the groups.”

This “study suggests what many doctors have long believed: While most prostate cancers are not life-threatening, a vast majority of men who receive the diagnosis are given aggressive treatments.”

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