PSA screening: new study

[Meadbh]

Gentlemen, here is a new article on PSA screening. The Canadian Task force on Preventive Health Care has reviewed all the evidence and has concluded that it does more harm than good on a population basis. They recommend that it be scrapped.

Of course, there will be individual men who say that their lives were saved because their prostate cancer was detected early due to having had the test. There will be others who had unnecessary treatment because the test was a false positive or detected a tumor that never would have been a problem in any case. Apparently the latter are in the majority.

PSA test should be abandoned as screen for prostate cancer, task force says - Health - CBC News

Recommendations on screening for prostate cancer with the prostate-specific antigen test

[travelover]

I just hope they don't recommend ending the digital exam. It keeps me and my doc bonded.

[Midpack]

Thanks Meadbh. A topic of interest to me after a PSA fiasco last Dec. It could get interesting with my GP during my upcoming annual physical.

[M Paquette]

I wish more of this sort of information had ben out when I first started having prostate problems.
I had an enlarged prostate that was beginning to interfere with flow (LUTS). I asked about going on finasteride, a compound that interferes with a growth signal to prostate cells and typically produces a slow shrinkage of the prostate over time.

The doctor didn't want to put me on finasteride as it would interfere with the PSA numbers (typically, it cuts the numbers in half), which would make it harder for him to see a trend in the data.

As a result of his wanting to see the test numbers, I wound up on intermittent catheterization. (Great for travel. Try explaining all that hardware to a TSA agent sometime. :yuck: ) Eventually I had a TURP procedure to restore flow, and am now on finasteride to keep things open.



Sent from my iPad using Early Retirement Forum

[Free To Canoe]

Thanks for posting.

"These recommendations apply to men considered high risk — black men and those with a family history of prostate cancer — because the evidence does not indicate that the benefits and harms of screening are different for this group."
Not even recommended for the high risk group!

I imagine that the test have value for monitoring once you are diagnosed via some other method, just not for screening.

[ERhoosier]

As the linked article shows, this remains a highly controversial topic. Here's an article from 11 years ago-
High PSA Level? Check it Again
Most prostate cancer is slow growing and many older men will die with their prostate CA but not because of it (i.e. prostate disease did not shorten their life). How PSA is used and interpreted has changed some over the years (like not testing within a few days of ejaculation or prostate/rectal exam which can elevate PSA). And treatments have been refined & improved. Some argue that data showing no survival advantage with screening testing does not reflect current medical/surgical management, but even if this is true it means more data will take years to collect. So men are still in the same boat when deciding to test or not
Here's an overview of the main issues (from primary care viewpoint)-
The PSA, prostate cancer and you – VCU Department of Family Medicine

[haha]

One thing for sure. Screening has a big time cheerleader in urology practitioners.

They can't easily switch to doing knee replacements or cataracts.

Ha

[donheff]

My doctor is not invested in testing but her practice routinely includes PSA in their blood tests. She brushes off the implications by saying we would just engage in watchful waiting if the test came back high. My problem is that high scores might induce a constant state of anxiety with no easy resolution. If you are not going to act on the test, better to not have the numbers in your face. I may request that the PSA test be dropped next time I am tested.

[target2019]

1. Do I want to know?
2. If I know, do I take action?