Recently the US Preventative Task Force issued new guidelines for Doctors to follow regarding the use of PSA (prostate-specific antigen) for screening men for prostate cancer.
Their recommendation came from a communication actually dated November 2009, and now recommends against routine screening by the use of the PSA blood test in all men, not just those greater than 75 years old, as the old guideline stated.
This new recommendation is not supported by many in the medical community that deal with mens’ health and prostate cancer on a daily basis.
Here are some of the facts surrounding this controversy.
- What is the prostate-specific antigen (PSA)? This a protein produced by the cells of the prostate gland and is used as a ‘biological marker’ to detect disease of the prostate.
- Why is the PSA test performed? The US FDA has approved the PSA to be used along with a digital rectal exam (DRE) to detect prostate cancer in men 50 years or older.
- For whom might a PSA screening test be recommended? Prior to the USPTF report, Doctors recommended routine screening by PSA and DRE for men 50 years of age and older or younger if they had a family history or were high risk for prostate cancer.
- What if the screening test results show an elevated PSA level? A man should discuss an elevated PSA test with his Doctor as there can different reasons for an elevation including prostate cancer, benign prostate enlargement, inflammation, infection, age and race.
- What are some of the limitations of the PSA test? Detecting tumors does not always mean saving lives as prostate cancer tumors can be very slow growing or fast growing and aggressive. There can be false-positive and false-negative tests leading to unnecessary tests or false reassurance.
- Why is the PSA test controversial in screening? It is not yet known for certain if this test actually saves lives and some of the follow up diagnostic tests and treatments for prostate cancer can cause harmful side effects.
The bottom line: PSA testing, by itself, is not recommended for screening for prostate cancer but requires discussion between the Doctor and the patient to determine his overall risk of prostate cancer and when this test should be performed.