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Age Limit on Prostate Cancer Screening?

Task Force Says Routine PSA Tests Not Needed for Men Age 75 and Older
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 5, 2008 -- A U.S. government task force says there is no "adequate proof" that routinely screening men over age 75 for prostate cancer leads to fewer deaths.

The U.S. Preventive Services Task Force now recommends against routine prostate-specific antigen (PSA) testing for men 75 or older who do not have symptoms, saying there's insufficient evidence that screening improves health outcomes.

"We carefully reviewed the available evidence to measure the benefits and harms of screening for prostate cancer and could not find adequate proof that early detection leads to fewer men dying of the disease," task force chair Ned Calonge, MD, MPH, chief medical officer for the Colorado Department of Public Health and Environment in Denver, says in a news release. "At this point, we recommend that men concerned about prostate cancer talk with their health care providers to make a decision based on their individual risk factors and personal preference."

The new recommendations update the panel's 2002 ruling, which concluded that there was not enough evidence to recommend screening for all men.

Prostate cancer is the second leading cause of cancer death in men (lung cancer is the first). According to the American Cancer Society, one in six men develop the cancer.

A PSA test can help doctors diagnose early prostate cancer, before symptoms develop. PSA is a protein released by prostate cells. The PSA test reveals how much of this protein is circulating through a man's bloodstream. All men have some amount of PSA in their blood. However, prostate cancer and other prostate disease can cause PSA levels to rise.

Men with prostate cancer might not have an elevated PSA. And the PSA test cannot tell the difference between cancer and a benign condition. A biopsy is needed to confirm cancer. Some scientists argue that routine PSA testing can lead to anxiety and unnecessary biopsies.

"Prostate-specific antigen screening is associated with psychological harms, and its potential benefits remain uncertain," the task force concludes in today's issue of Annals of Internal Medicine. The panel says more conclusive evidence is needed to determine the balance of benefits and harms of prostate screening in men younger than 75.

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