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One-Time PSA Test at 60 Instead of Routine Screening?
"September 16, 2010 — New data suggest that a 1-time prostate-specific antigen (PSA) test at age 60 can pinpoint men who are likely to die from prostate cancer.
The results, published online September 14 in BMJ, come from a Swedish study with a 25-year follow-up.
The finding "needs to be validated in additional studies," according to an accompanying editorial. The researchers agree there is a need for replication by an independent team; nevertheless, they are enthusiastic about their results.
"This is a key finding," said lead research Andrew Vickers, PhD, from the Department of Epidemiology and Biostatistics at the Memorial Sloan-Kettering Cancer Center in New York City.
"We know that screening detects many prostate cancers that are not harmful, leading to anxiety and unnecessary treatment," he said in a statement. Indeed, a separate study published online September 14 in BMJ found no support for routine PSA screening in all men.
The approach the study authors propose — of testing once at age 60 — pinpoints men who are at increased risk for "really aggressive cancers, the sort likely to lead to symptoms or shorten a man's life," Dr. Vickers said. His team found that most of the deaths from prostate cancer were among the 25% or so of men who had, at age 60, PSA levels higher than 2 ng/mL.
The team originally started their study with the hope of finding a new biomarker for prostate cancer. "What we found instead was a new way of using an old test," Dr. Vickers said...."
http://www.medscape.com/viewarticle/728662?sssdmh=dm1.637637&src=nldne&uac=39980BG
The results, published online September 14 in BMJ, come from a Swedish study with a 25-year follow-up.
The finding "needs to be validated in additional studies," according to an accompanying editorial. The researchers agree there is a need for replication by an independent team; nevertheless, they are enthusiastic about their results.
"This is a key finding," said lead research Andrew Vickers, PhD, from the Department of Epidemiology and Biostatistics at the Memorial Sloan-Kettering Cancer Center in New York City.
"We know that screening detects many prostate cancers that are not harmful, leading to anxiety and unnecessary treatment," he said in a statement. Indeed, a separate study published online September 14 in BMJ found no support for routine PSA screening in all men.
The approach the study authors propose — of testing once at age 60 — pinpoints men who are at increased risk for "really aggressive cancers, the sort likely to lead to symptoms or shorten a man's life," Dr. Vickers said. His team found that most of the deaths from prostate cancer were among the 25% or so of men who had, at age 60, PSA levels higher than 2 ng/mL.
The team originally started their study with the hope of finding a new biomarker for prostate cancer. "What we found instead was a new way of using an old test," Dr. Vickers said...."
http://www.medscape.com/viewarticle/728662?sssdmh=dm1.637637&src=nldne&uac=39980BG
Mike, we understand that you aren't vouching for the study; I didn't read the entire article, only what you posted.
I think we've all had experiences that tell us that a "one time" screening might not be a good choice.
I'm happy to hear, though, that you aren't particularly at risk right now; I would never wish that on anyone.
I think we've all had experiences that tell us that a "one time" screening might not be a good choice.
I'm happy to hear, though, that you aren't particularly at risk right now; I would never wish that on anyone.
As far as I know I am not at risk for Prostate Cancer.
I don't vouch for the study - I just read it and posted it.
I am not sure who has read the entire article and really, maybe that doesn't matter.
Mike
I don't vouch for the study - I just read it and posted it.
I am not sure who has read the entire article and really, maybe that doesn't matter.
Mike
My dad was dx'd with prostrate cancer at the same time as a friend of mines dad. My dad treated aggressively while their dad died in six months. I can't think over screening is a bad thing at all especially if something is in a family history.
From counseling for kids who struggle with their weight, to cancer screenings for their parents, preventive health care will soon be available at no out-of-pocket cost under consumer rules the Obama administration unveiled Wednesday.
That means no copays, deductibles or coinsurance for people whose health insurance plans are covered by the new requirements.
That means no copays, deductibles or coinsurance for people whose health insurance plans are covered by the new requirements.
Thank you Mike. Trust me, I get very nervous waiting for those results every year. If you're in line for prostrate cancer, I wish you luck as well. I truly hope you never get it. It sounds like an awful disease. I have to wonder about the motivations of those who wish to decrease cancer screening. Money shouldn't be the primary concern. And as mammograms are fully covered under insurance, so should prostrate cancer exams.
That's great - I wish you good luck every year.
Maybe if you were a male and your father died of prostrate cancer you'd be among those for whom frequent PSA testing is recommended.
It's always better to be safe than sorry.
Mike
Maybe if you were a male and your father died of prostrate cancer you'd be among those for whom frequent PSA testing is recommended.
It's always better to be safe than sorry.
Mike
When it comes to cancer, I think that over-diagnosing is preferable to under diagnosing. The same for the study concerning mammograms. My mom died of breast cancer and I'm tested every year whether the powers that be approve or not.
Of course, I agree with you Barb about one size fits all.
The results of the study may argue for decreased PSA testing frequency and may affect decreased "overdiagnosis". That's about it - risk stratification.
[..."We haven't totally solved the problem of overdiagnosis," Dr. Vickers explained. Many patients who have a higher than average PSA at age 60 will develop prostate cancers that are unlikely to lead to death. "Nonetheless, it is clear that risk-stratifying screening will reduce overdiagnosis in men at low risk of prostate cancer death and will improve compliance with screening in those men with most to benefit," he added.]
Mike
The results of the study may argue for decreased PSA testing frequency and may affect decreased "overdiagnosis". That's about it - risk stratification.
[..."We haven't totally solved the problem of overdiagnosis," Dr. Vickers explained. Many patients who have a higher than average PSA at age 60 will develop prostate cancers that are unlikely to lead to death. "Nonetheless, it is clear that risk-stratifying screening will reduce overdiagnosis in men at low risk of prostate cancer death and will improve compliance with screening in those men with most to benefit," he added.]
Mike
As one who has family members who have had prostate cancer, I'm not sure I like this approach, but I'm not sure what "markers" they would use to determine who is or isn't susceptible.
My stepfather had normal PSA tests for many years, then suddenly in his 80's, he was dx'd with prostate cancer; he died from it in 2000 at age 84. Additionally, I have a brother who also had routinely tested "normal" on PSA tests; however, he also ended up being dx'd. Fortunately, they caught his in time; he had a surgery, took some med and today, is alive and well at 73.
Of course, we always hope for tests that will indicate a susceptibility to certain things, but from my own experience of suffering from an undiagnosed disease for way too long, I find that doctors too often focus on only one aspect of a condition/disease and refuse to look further. Another test run, indicating a "marker" for the undiagnosed disease was ultimately put down to something else - I went untreated for way longer than I needed to.
I often fear that some medical treatments/tests are getting into the "one size fits all" category and I find that very scary.
While we all hope for things that might lower the cost of health care, I do hope things like this proceed with caution, so as to prevent misdiagnosis or undiagnosis.
My stepfather had normal PSA tests for many years, then suddenly in his 80's, he was dx'd with prostate cancer; he died from it in 2000 at age 84. Additionally, I have a brother who also had routinely tested "normal" on PSA tests; however, he also ended up being dx'd. Fortunately, they caught his in time; he had a surgery, took some med and today, is alive and well at 73.
Of course, we always hope for tests that will indicate a susceptibility to certain things, but from my own experience of suffering from an undiagnosed disease for way too long, I find that doctors too often focus on only one aspect of a condition/disease and refuse to look further. Another test run, indicating a "marker" for the undiagnosed disease was ultimately put down to something else - I went untreated for way longer than I needed to.
I often fear that some medical treatments/tests are getting into the "one size fits all" category and I find that very scary.
While we all hope for things that might lower the cost of health care, I do hope things like this proceed with caution, so as to prevent misdiagnosis or undiagnosis.
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