Panel's Rejection of PSA Test Spurs Mixed Reaction From Experts

Many still stick by the prostate cancer screen, claiming it saves lives

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Brawley believes men must have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after they receive information about the uncertainties, risks and potential benefits associated with testing for early prostate cancer detection.

"The ACS also strongly asserted that prostate cancer screening should not occur without an informed decision-making process," Brawley added.

D'Amico, who supports PSA testing, added that while over-treatment based on PSA test results has been a problem, much of that can be eliminated if the test is based on the most accurate PSA results. To make the test more accurate, men should stay away from sexual activity just prior to the test, bike riding, horseback riding and colonoscopy, he said. In addition, they should not have a PSA test if they have a bladder or prostate infection; and should wait at least a month after it has cleared up.

"Also, once a person is diagnosed it doesn't mean that they have to undergo treatment -- they can have a discussion with their physician about the significance of this cancer," D'Amico said. "Diagnosing allows one to have the opportunity to understand whether this is a cancer that requires treatment or not. But, putting your hands over your eyes saying, 'I don't want to know,' actually can lead to unnecessary death."

"I would still recommend an annual PSA, particularly for men who are healthy and under 65," D'Amico concluded.

Another expert, Dr. Lionel L. Banez, also supports continued use of the test. Banez, an assistant professor in the division of urologic surgery at Duke University Medical Center, said "the draft of the USPSTF review does provide evidence that PSA screening reduces prostate cancer mortality -- albeit not in as great a magnitude to be called optimal."

Prostate cancer remains the second most common cause of cancer death in men after lung cancer, Banez noted. "Thus, a slight reduction in mortality could still translate in a substantial absolute number of lives saved. Though it is clear that we still need to find a better test to improve early detection of significant disease and to curtail over-treatment, it is not advisable to discourage use of a currently existing test that is proven to save lives," he said.

More information

For more on prostate cancer, visit the U.S. National Cancer Institute.

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