To PSA Or Not To PSA?

[♥ COVID-19♥]

Prostate Cancer Screening Shows No Benefit

Updated findings from one of the largest studies of prostate cancer screening show that the commonly used P.S.A. blood test did not save lives, although questions remain about whether younger men or those at very high risk for the disease might benefit.

Last fall, the United States Preventive Services Task Force concluded that healthy men should no longer be routinely screened for prostate cancer using the prostate-specific antigen, or P.S.A., blood test. That decision was based on findings from five well-controlled clinical trials, including a major American study called the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial, which studied P.S.A. testing in nearly 77,000 men ages 55 to 74.

In 2009, the PLCO trial reported that although annual P.S.A. screening did detect more cancers, it didn’t save more lives when compared with a group of men who were given routine medical care and tested for prostate cancer only when a problem was suspected. But at the time, the investigators had only 7 to 10 years of data. Because prostate cancer can take several years to develop, the investigators continued to collect data after reporting the initial findings.

So if there's no benefit, why even bother getting tested?

[Chicago Jake]

One argument against testing that has no discernible benefits is that every test carries with it some amount of risk. And why suffer the risk if there is no reward?

However, PSA testing is pretty much risk free. It is a blood test, and if you are getting a blood test for ANY other reason (such as cholesterol screening), there is no downside to also doing the PSA on the sample while you're at it. Well, no down side in terms of medical risk, anyway. There is the cost of the doing the test, which one might argue isn't worth it.

I guess what I'm saying is, I can see both sides of this argument, but don't feel qualified to have an actual opinion on it.

And there's always the DRE, which is more fun, anyway!

[♥ COVID-19♥]

Another aspect: if there is no benefit derived from the test, then how long will it be before insurance companies stop covering its cost?

[Chicago Jake]

Actually, your article doesn't say "no benefit;" it just says that it didn't save more lives. But what about quality of life? If you detect a cancer earlier, you might be able to live with the results more comfortably. Losing the functions of several important organs may not kill you, but it is sure nice to hang on to them if you can.

[♥ COVID-19♥]

Well, the *title* says "no benefit". Given the fact that treatment for prostate cancer causes impotence, incontinence or-- in some cases -- both, it's questionable how much quality of life would actually remain.

[Ardbeg... innit]

I had my annual back in November. My doctor and I were talking about this. He was saying that right now everything is in flux regarding recommended procedures. At that point he was saying that they would probably go to 2 year tests up to age 65, and nothing after that. Most prostate cancers are so slow in developing that after 65 if one develops odd are that it really wouldnt make much difference in your overall lifespan anyway.

[Chicago Jake]

Jan 6, 2012 17:43:14 GMT -6 ♥ COVID-19♥ said:

Well, the *title* says "no benefit". Given the fact that treatment for prostate cancer causes impotence, incontinence or-- in some cases -- both, it's questionable how much quality of life would actually remain.

Those are more likely to occur in advanced stages of the cancer. Early detection means less aggressive treatment which means less risk of impotence or incontinence. Hence the argument in FAVOR of screening and finding it earlier.

And titles are written by editors, not reporters. Often editors who didn't bother to read the article.

[♥ COVID-19♥]

Jan 7, 2012 0:17:38 GMT -6 Chicago Jake said:

And titles are written by editors, not reporters. Often editors who didn't bother to read the article.

I'm not going to try to discuss journalism here, but I think if any shortcuts are taken, it's more to do with space-saving concerns. That said, I don't think the title of the piece is a gross misrepresentation of the gist of the article.

[Chicago Jake]

I'm still waiting for Dr. Bob to weigh in on this issue, so SOMEBODY who knows what they are talking about can set us straight.

[Exildo Wonsetler Briggs III]

A single PSA doesn't tell you much. BUT, if you had one last year, and the result was 1.0, and you have one this year, and the value was 100, there's a problem.

The ability to use a SINGLE PSA result is questionable. When your PSA suddenly rises significantly compared to previous results, you might want to check your prostate carefully.

...........Bob