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Most Men Don't Need PSA Tests, Doctors' Group Says

American College of Physicians notes limited benefit of prostate cancer screening

WebMD News from HealthDay

By Serena Gordon

HealthDay Reporter

MONDAY, April 8 (HealthDay News) -- Men have long been encouraged to get prostate cancer screenings, but there's insufficient evidence that the benefits of a PSA test outweigh the substantial risks associated with the screening.

That's why the American College of Physicians (ACP) announced new guidelines Monday that recommend that men between the ages of 50 and 69 years old should discuss the limited benefits of the prostate-specific antigen (PSA) test with their physicians.

It's equally important that men understand the risks associated with this test, which can lead to additional testing and treatment that may not be necessary for slow-growing prostate cancers, the ACP said.

"By and large, the data doesn't support routine screening because the outcomes aren't better. For the significant majority of men who have a relatively benign form of prostate cancer, that cancer isn't likely to give them problems in their lifetime," said Dr. David Bronson, president of the American College of Physicians, and a professor of medicine at the Cleveland Clinic.

"Men need to know that they have choices. Have a discussion with your physician. Have a long conversation about the pros and cons," Bronson suggested.

As many as one in six men will be diagnosed with prostate cancer in their lifetime, research shows. Yet, only less than 3 percent of men will die from the disease. Most of the deaths related to prostate cancer occur in men older than 75 years, according to the experts.

Screening for prostate cancer is easy. The PSA is measured through a simple blood test. Knowing what to do with the PSA result is far from simple, however.

PSA measures the level of prostate-specific antigen in the blood. In general, the higher the level of this protein, the more likely it is that a man has prostate cancer, according to the U.S. National Cancer Institute (NCI). But, not everyone with an elevated PSA has prostate cancer. And, PSA doesn't tell your doctor how aggressive a potential cancer might be.

Because of this uncertainty, if a man who isn't having symptoms has an elevated PSA after a screening test, the test is usually repeated. If it's still elevated, a man may choose to wait and have the test repeated again at a later date, or his doctor may recommend a prostate biopsy, according to the NCI. This is usually done through the rectum, using ultrasound to guide the needle. There's a risk of infection from this procedure. And, even with a biopsy, it's not clear which men have aggressive forms of cancer and those who have slower-growing cancer.

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