PSA Testing For Prostate Cancer, A New Study


MONDAY, July 30 (HealthDay News) -- In the deathwatch of a broadly publicized address advising adjoin prostate-specific antigen (PSA) testing for prostate cancer, a new abstraction finds not screening would amateur the cardinal of U.S. men developing avant-garde cancer.

Testing, on the added hand, ability accumulate some 17,000 men anniversary year from accepting a analysis of late-stage prostate blight -- blight that has advance and is far beneath curable -- the abstraction finds.

"PSA testing, for all its assets and minuses and all that . . . permits you to bolt the ache earlier," said advance
researcher Dr. Edward Messing, armchair of urology at the University of Rochester Medical Center in Rochester, N.Y.

"These bodies are all activity to die, they are activity to die abundantly expensively and die miserably," he said, apropos to the abounding men whose diagnoses would be delayed by not testing. "I don't apperceive that all these bodies could be adored with PSA testing," but abounding could, he added.

The address was appear online July 30 in the account Cancer.

Messing said the anniversary cardinal of prostate blight deaths alone from about 42,000 in the 1990s to 28,000 now. "The alone affair that can explain that is PSA aboriginal apprehension and treatment," he said.

Many cases of prostate blight are not life-threatening, which is why testing is controversial. The U.S. Preventive Services Assignment Force (USPSTF) in May recommended adjoin accepted PSA screening, adage too abounding non-lethal cancers were actuality advised aggressively, advertisement men who didn't charge analysis to austere ancillary furnishings such as abstention and urinary incontinence.

But Messing disagreed with that advice. Condemning PSA testing "wasn't a ablaze conclusion," he said.

For the new study, Messing's aggregation compared advice from the U.S. Surveillance, Epidemiology, and End Results database for the years 1983 to 1985 -- anon afore boundless PSA testing started --- to abstracts from 2006 through 2008.

In the 2008 data, 8,000 cases of prostate blight were diagnosed afterwards the blight had advance to added genitalia of the body.

Using these cases as a base, the advisers complete a archetypal that acclimated abstracts of avant-garde blight diagnosed in the 1980s and predicted how abounding cases of avant-garde blight would accept been diagnosed in 2008 if PSA testing was not done.

Their archetypal showed instead of 8,000 absolute cases in 2008, about 25,000 cases would accept been diagnosed.

But the USPSTF maintains the allowances of testing are overrated. "The assignment force recommends adjoin prostate blight screening application the PSA test, as the abeyant account does not outweigh the harms," said Dr. Michael LeFevre, co-vice armchair of the assignment force and assistant in the administration of ancestors and association anesthetic at the University of Missouri School of Medicine.

As a aftereffect of treatments for PSA-detected prostate cancer, one out of 1,000 men buried in the United States develops a claret array in his legs or lungs, two will accept a affection advance or stroke, and up to 40 are larboard barren or with urinary incontinence, LeFevre said.

"At best, alone one of these 1,000 men who were buried avoids dying from prostate blight for at atomic 10 years," LeFevre said. "In addition, about one in every 3,000 men buried dies as a aftereffect of anaplasty to amusement blight detected by the PSA test."

Still, the assignment force recognizes that "some men may abide requesting the PSA analysis and some physicians may abide alms it," LeFevre said.

Before accepting this claret analysis -- which measures a protein in beef of the prostate gland -- men should apprentice about the pros and cons, he said. "The accommodation to alpha or abide screening should reflect an compassionate of the accessible allowances and accepted harms, and should account anniversary individual's preferences."

Messing advises men with a ancestors history of prostate blight or urinary affection to accept a PSA test. Men with no ancestors history or affection should altercate PSA testing with their doctor, he added.

Messing acicular out that screening-detected blight doesn't beggarly surgery, chemotherapy or radiation analysis charge follow. Most cases can be watched for some time, he said.

Dr. Otis Brawley, arch medical administrator for the American Blight Society, said over the accomplished few years a cardinal of studies accept been appear on the allowances and harms of PSA testing.

"None of these studies can be advised absolute added than in proving that there are some harms associated with treatment," he said. The American Blight Society still supports screening for assertive men in appointment with a physician.

Prostate blight is the second-leading account of blight afterlife amid men in the United States. In 2012, added than 240,000 new cases are accepted to be diagnosed, and 28,000 men will die from the disease, advisers say. 

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