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Prostate Test Questioned

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The Washington Post

Published: August 5, 2008

Updated: 08/05/2008 10:28 am

WASHINGTON - The blood test millions of men undergo each year to screen for prostate cancer leads to so much unnecessary anxiety, surgery and complications that doctors should stop testing elderly men, a panel of experts said.

It remains unclear whether the test is worthwhile for younger men, the task force concluded Monday.

In the first update of its recommendations for prostate cancer screening in five years, the widely respected panel that sets government policy on preventive medicine said the evidence the test reduces the cancer's death toll is too uncertain to endorse routine use for men at any age, and the potential harms clearly outweigh any benefits for men age 75 and older.

"The benefit of screening at this time is uncertain, and if there is a benefit, it's likely to be small," said Ned Calonge, who chairs the 16-member U.S. Preventive Services Task Force. It published the new guidelines in the Annals of Internal Medicine. "And on the other side the risks are large and dramatic."

The task force and other groups had concluded previously that it was unclear whether the benefits of the prostate-specific antigen, or PSA, test outweigh the risks.

The new review of scientific literature found no evidence to alter that assessment for younger men but that enough new data had emerged to recommend for the first time against screening for older men.

"We felt with sufficient certainty that your risk of being harmed exceeded your potential benefits starting at age 75," Calonge said.

"There is this idea that more is always better, and if a test is available we should use it," said Howard A. Brody, a professor of family medicine at the University of Texas Medical Branch at Galveston.

"A lot of time we're doing more harm than good," Brody said.

The guidelines - which address perhaps the most important and contentious issue in men's health - were praised by officials at several leading medical groups, including the National Cancer Institute and the American Cancer Society.

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