Stop PSA Tests

Australian doctors say stop PSA tests:

A group representing Australian general practitioners says the risks of being screened for prostate cancer outweigh the benefits.

In its latest book of preventative health guidelines, the Royal Australian College for GPs advises its members not to recommend prostate cancer screening to patients.

Professor Chris Del Mar from Bond University on the Gold Coast says the process is invasive and can lead to health problems.

“To find out whether you’ve got it involves an involved diagnostic procedures, a biopsy done through the rectum into the prostate,” Professor Del Mar said.

While there’s a 50 per cent chance men over the age of 60 will have the disease, Professor Del Mar says prostate cancer is entirely benign in most cases.

Professor Del Mar says if he had the disease, he would not want to know.

“The chances are – still – that it won’t ever shorten my life,” he said.

He says patients who are tested often develop serious infections, erectile dysfunction and urinary incontinence.

Professor Del Mar says he is concerned about public awareness campaigns encouraging men to be screened for prostate cancer.

“There’s a lot of confusion in the minds of GPs and the general public,” he said.

“Screening for prostate cancer ends up doing more harm than good.”

The college has always opposed screening for prostate cancer and says, increasingly, medical literature supports its position.


By Monte Morin Los Angeles Times

LOS ANGELES — A new study of prostate cancer suggests that a tumor’s aggressiveness is inherently fixed at the time of its appearance, although diet, lifestyle and environmental factors may trigger progression of the disease in low-level cases. The findings, published Wednesday in the journal Cancer Research, add to mounting evidence that many small, slow-growing prostate tumors can be left in the body and carefully monitored instead of being treated with surgery, radiation, hormone therapy or drugs. Doctors call this approach “active surveillance,” and it’s increasingly seen as a way to reduce the risk that men will suffer side effects like incontinence and erectile dysfunction after treating tumors that would not have killed them. The National Cancer Institute estimates that 238,590 men will be newly diagnosed with prostate cancer this year, though the tumors are generally slow-growing and most patients will die of something else. Researchers set out to determine whether prostate tumors begin as indolent growths and become more dangerous over time, or whether their level of aggressiveness remains constant. To accomplish this, the study authors examined 1,200 cases of men who had their prostates removed from 1982 to 2004 because of cancer. The sample consisted of men who were diagnosed before and after the introduction of the prostate-specific antigen test in the early 1990s, which became a popular tool to diagnose prostate cancer in men who had not yet developed symptoms of the disease. The researchers focused on two measures that are often used to predict a tumor’s behavior. “Stage” describes the extent to which a cancer has spread. “Gleason score” describes just how normal or abnormal cells are within in the diseased tissue. As expected, the incidence of advanced-stage cancers plummeted after the introduction of PSA screening, because more cancers were caught early . Late-stage cancers, defined as T3 or higher, made up 20 percent of the cases diagnosed from 1982 to 1993, but constituted only 3 percent of the cases diagnosed from 2000 to 2004, the researchers discovered. In contrast, the number of high Gleason score cancers — those above 8 — held relatively steady: They made up 25 percent of the sampling from 1982 to 1993, and dropped to 18 percent in 2000 to 2004. That difference was not deemed statistically significant.