One of the most widely used prostate cancer screening techniques can detect cancer many years before other evidence of the disease develops.  Prostate cancer is a slow-growing cancer, often taking ten years or longer to become evident.  It is the slow-growing nature of this particular form of cancer that has led the US Preventive Services Task Force to recommend the prostate-specific antigen (PSA) test be eliminated from routine medical screening in men age 75 and older as well as for younger men in certain situations.

A man at the age of 75 has little more than 10 years left to his natural life expectancy.  He is much more likely to die from other causes than from a recently diagnosed case of prostate cancer.  It’s not likely that any trace of prostate cancer will produce symptoms during the remainder of a 75-year-old man’s remaining life but knowing he is PSA positive can lead to anxiety and depression that would have been avoided without the screening results.  Oftentimes, a positive PSA screening will lead to biopsies and treatments that may not be necessary.  Many of the standard methods of treating prostate cancer produce  impotence and urinary incontinence, two conditions that many may have never been otherwise encountered by a particular patient.

Because of the slow rate of growth in prostate cancer and the complications treatment can bring, men younger than age 75 who have other conditions that reduce their life expectancies may want to consider foregoing PSA screening, too.  Two clinical trials that are currently under way (the National Cancer Institute’s Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the European Study of Screening for Prostate Cancer) are exploring the pros and cons of PSA screening in men younger than 75.

In 2007, approximately 218,890 men in the US received a diagnosis of prostate cancer.  It is estimated that one in every six men will be diagnosed with the disease at some point in life.

The Annals of Internal Medicine’s August 5 issue carries the full details of the task force recommendations.  The task force, comprised of a panel of independent experts specializing in prevention and primary care, is chartered with conducting rigorous but impartial assessment of many medical services and its recommendations are considered the gold standard by which clinical preventive services are measured.

Source: AHRQ