A prostate-cancer test linked to an over-diagnosis of the disease needs to be used rationally, not abandoned, surgeons said at a medical meeting in Australia
Getting a so-called PSA test
in their 40s can help men and their doctors gauge cancer risk, according to a statement signed by 11 urologists from 10 universities in five nations. Healthy seniors with at least a decade of life expectancy
shouldn’t be denied the exam, the surgeons said at the Prostate Cancer World Congress in Melbourne Tuesday.
The six-point consensus statement is a response to advice by a U.S. panel against using the PSA test for prostate-cancer screening. The test measures a protein made by prostate cells known as prostate-specific antigen and can’t detect cancer or distinguish between benign tumors and malignant ones. Discovered in 1970, it has led to earlier diagnoses but also to impotence and incontinence in men treated for non-lethal tumors.
“Abandonment of PSA testing would lead to a large increase in men presenting with advanced prostate cancer and a reversal of the gains made in prostate-cancer mortality over the past three decades,” the doctors said in the statement. Deaths from the disease have declined by more than 30 percent since testing started, they said.
Worldwide, almost 900,000 men
were diagnosed with prostate cancer in 2008, making it the second most-common malignancy in males, and about 258,000 men died of the disease, according to the International Agency for Research on Cancer in Lyon. The U.S. Preventive Services Task Force
said last year that the PSA test isn’t worth the risk.
The statement also called for prostate-cancer diagnosis to be uncoupled from prostate-cancer intervention.
“Many men with low-risk prostate cancer do not need aggressive treatment,” according to the statement, which supports so-called active surveillance or watchful waiting as a strategy to avoid treating men with indolent tumors.
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