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PSA Screening Benefits Young men

Wednesday, 09 May 2012 11:50 AM

PSA screening to detect prostate cancer can be beneficial to younger and at-risk men, according to a new analysis of studies that aims to settle the debate over the test’s risks and benefits.
The analysis, published in the Canadian Medical Association Journal, found prostate-specific antigen (PSA) screening reduces the risk of metastatic prostate cancer and deaths and should not be abandoned.
The conclusions by researchers at Erasmus University Medical Centre in the Netherlands do not support the draft guidelines issued by the United States Preventive Services Task Force that recommend against PSA screening for men of all ages.
Researchers noted the American Cancer Society and the American Urological Association both recommend that men be given a choice about whether they should be screened. The Canadian Task Force on Preventive Health Care, which recommended against PSA screening in 1994, is expected to issue updated recommendations in 2013.
Experts note that studies have reached conflicting findings on the benefits of PSA testing in younger men. A recent study of 162,243 men in Europe -- aged 55 to 69 years – found screening reduces deaths caused by prostate cancer. But other trials, such as the U.S. Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, showed no benefit in screening.
But the Netherlands researchers noted PSA screening reduces the incidence of metastatic cancer – when tumors spread beyond the prostate. The European study found a 41 percent reduction in metastatic disease with screening.
The authors concluded that a decision about PSA screening be determined by each individual patient and his doctor. For elderly men with multiple health conditions, screening may be more harmful than beneficial, but for younger, healthy men, screening can reduce death from prostate cancer. Healthy younger men also are at lower risk of complications from biopsies and treatments.

"Cancer-specific mortality, not overall mortality, is the primary outcome in screening trials," said Dr. Monique Roobol, who helped lead the new study. "Rather than abandoning a screening test that reduces death and suffering, efforts should be focused on selecting patients more carefully.
"Screening should be encouraged for healthy younger men and men with risk factors and discontinued for elderly men with multiple comorbidities and limited life expectancy."

© HealthDay

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An analysis of prostate cancer studies finds PSA screening is a good idea for younger and at-risk men.
Wednesday, 09 May 2012 11:50 AM
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