Study and Urology Experts Confirm Test’s Value
June 2012, Denver, CO: While the U.S. Preventative Services Task Force (USPSTF) has recommended that healthy men should not receive prostate-specific antigen (PSA) blood testing for the detection of prostate cancer, all Advanced Urology board-certified urologic surgeons believe in the value of PSA testing. Results from the largest study on PSA testing, published in March 2012, support the PSA’s effectiveness in detecting cancer early and aiding in better survival for patients.
PSA Testing is Vital
- The largest study on PSA screening found it can reduce prostate cancer related deaths by 21 percent. This study involved 182,000 men ages 50-74 with results published in the New England Journal of Medicine (March 2012). Also, for men with the longest follow-up (more than 10 years), the decrease in prostate cancer deaths fell 38 percent. Prostate cancer is typically a slow-growing cancer, so it is this 10-year data that is the most important.
- Since the introduction of PSA testing in the mid 1990’s, 90 percent of all prostate cancers now are discovered before they spread. At this stage, the five-year survival rate is nearly 100 percent. Before PSA screening was available, 50 percent of newly diagnosed prostate cancer patients were diagnosed with metastatic disease. By diagnosing most prostate cancers at an early stage, PSA testing allows patients to consult with their physicians about the multiple treatment options, including watchful waiting. Without early detection, most of these options are no longer available.
Shortcomings in the USPSTF Recommendations Against PSA Screening
- The USPSTF wrongly recommends PSA testing only in men presenting with prostate cancer symptoms. Unfortunately for many men this first symptom doesn’t occur until late in the course of illness from painful metastatic disease, and unfortunately the cancer is no longer curable at this stage.
- The USPSTF contends that screening with PSA leads to unnecessary testing and over-treatment. This ignores the many research studies addressing tumor behavior and patient outcomes that have resulted in expanded use of appropriate surveillance protocols. After shared doctor/patient decision-making, many men with low-risk prostate cancer are appropriately placed on watchful waiting. In fact, Advanced Urology currently places approximately 25 percent of newly diagnosed prostate cancer patients on a watchful waiting protocol that we have developed.
- The USPSTF recommendations do not adequately consider the high-risk patients such as those with a family history of prostate cancer and African American citizens who, as a race, are at the highest risk of developing high-grade cancer of the prostate.
“Early screening using the PSA test remains the best way to save men from prostate cancer,” explains Dr. Geoff Ledgerwood. Every physician at Advanced Urology believes in PSA testing for early detection and will continue to follow the American Urologic Association’s guidelines for early detection and risk assessment.
Prostate Cancer Screening Recommendations
The American Urologic Association’s (AUA) guidelines for prostate cancer detection state: early detection and risk assessment, including the PSA test and the DRE (Digital Rectal Exam), should be offered to men 40 years of age or older who wish to be screened. The key to effective use of the PSA test is patient education and a healthy collaboration between the physician and patient.
About PSA Testing
The Prostate-Specific Antigen (PSA) test has been offered as a screening tool for more than a decade. This simple blood test measuring the level of prostate-specific antigen is non-invasive, low-cost and highly effective (when offered with patient education). While PSA levels can rise for reasons other than prostate cancer (such as Benign Prostatic Hyperplasia and prostatitis), physicians can use an abnormal PSA levels to recommend further testing to diagnose prostate cancer.