The rate of screening for prostate cancer with PSA
testing has remained unchanged in elderly men despite a 2008 U.S.
Preventive Services Task Force recommendation against such testing,
according to a research letter in JAMA.
Using data from the National Health Interview Survey, investigators
compared PSA screening rates in 2005 and 2010. (In 2008, the USPSTF
recommended against screening in men aged 75 and older.) In all age
groups — including the elderly — screening rates remained unchanged in
the two periods.
The authors say the discrepancy between the recommendation and the
observed practice pattern "may reflect lack of guideline awareness,
financial incentives, or patient or physician confidence in PSA
screening."
n this edition of Medscape One-on-One, host and Medscape Editor-in-Chief Eric J. Topol, MD, interviews Richard J. Ablin, PhD, DSc (Hon), who first discovered prostate-specific antigen (PSA) in 1970. At the time, Dr. Ablin and colleagues were trying to identify an antigen that was specific to prostate cancer. What Dr. Ablin identified instead was that PSA was present not only in malignant prostates but also in benign prostates. He did agree, however, that elevated levels of PSA might be useful in predicting a recurrence of prostate cancer in men who were thought to be in remission.
ReplyDeleteIt was much to Dr. Ablin's dismay that more than 2 decades later, in the mid-1990s, the US Food and Drug Administration (FDA) approved the use of PSA not only to test for recurrence of cancer, but also as a possible predictor of cancer. Since then, Dr. Ablin maintains, the United States spends billions each year administering a preventive prostate cancer screening test to men, using PSA, that produces false positives in the majority of cases. In his interview with Dr. Topol, Dr. Ablin explains why physicians and patients should proceed with caution when using PSA as a marker for preventive screening.