Study: Prostate Screening Saves Lives
PSA Tests Cut Metastatic Prostate Cancer by 35%
WebMD News Archive
"It was astonishing," Coltman says. "We found individuals with
prostate cancer at every range of PSA --from 4 down to 0.1. And a substantial
number of them had high-grade prostate cancer. In fact, some of these cancers
were in men who had gone through seven years of PSA and digital rectal exams
and were found to be normal in all respects."
What's a Man to Do?
The American Cancer Society recommends that men over 50 -- or high-risk men
over 45 -- discuss with their doctors whether they should begin annual PSA
tests and digital rectal exams. Men at high risk include blacks and those with
a family history of prostate cancer. Men at especially high risk -- those with
multiple first-degree relatives who have prostate cancer -- may wish to begin
this conversation even earlier, at age 40.
Even though he's not blind to its faults, Coltman says that men should
discuss PSA testing with their doctors.
"I don't think one should dissuade a man from prostate screening,
because in fact the screening may show the PSA is elevated and his prostate
gland is abnormal," he says. "But doctors must understand that we are
going to rewrite the book. Because if PSA is less than 4 or even less than 2.5,
you cannot be totally confident there is not a problem."
Coltman suggests that current PSA cutoff levels may be appropriate for men
not at high risk. For those in high-risk groups, he suggests that doctors seek
biopsies when they detect prostate abnormalities -- even if a patient's PSA is
below the current cutoff.
Deciding on prostate cancer screening is a matter of weighing the benefits
against the risks. The benefit: catching a deadly prostate cancer while it is
still curable; the risk: unnecessary biopsy and, perhaps, surgery or radiation
therapy for cancer that would never have been a problem if it hadn't been
Large studies are under way to help men make this difficult decision. But
results won't be available for a long time.
"We don't expect results before the end of this decade -- or well into
the next decade," Coltman says.