Prostate cancer screening fails to provide definitive benefits
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BY DELTHIA RICKS | delthia.ricks@newsday.com
Two new studies into PSA (prostate-specific antigen) screening for prostate cancer this week raised more questions than they answered, according to the American Urological Association. Dr. Felix Badillo, chief of urology at St. Francis Hospital; Dr. Howard L. Adler, medical director of Stony Brook University's prostate care center; and Dr. Louis Kavoussi, chairman of urology at North Shore-LIJ Health System, offered clarity.
Does PSA screening reliably detect cancer?
Yes and no. It also spots inflammation in the prostate, which may sound a false alarm, a reason its reliability has been questioned. Even when cancer is present, Adler noted, a PSA also cannot help distinguish between aggressive and indolent tumors. Indolent cancers, slow-growing malignancies, are less likely to spread, requiring nothing more than "watchful waiting."
The new studies, one by Americans and the other by Europeans, drew different conclusions. The Americans found "no benefit" from PSA screening; the Europeans found a negligible benefit. Why the difference?
The studies involved different investigational techniques and different populations. The urological association issued a statement saying studies such as these are just part of the national discussion about PSA testing. An overwhelming body of evidence exists supporting the value of the test and the potential to save lives.
The studies suggest there is no "survival benefit" from routine screening. What does that mean?
When the PSA was developed in the 1980s, experts theorized a widespread mortality reduction, as was seen with mammography and breast cancer. That didn't happen. However, Badillo emphasized that the benefits of screening far outweigh the risks of forgoing the test, especially for men at risk because of family history or those between the ages of 50 and 75.
What about men who are older?
Men in their 80s and 90s can choose to be screened less frequently. As men age, the prevalence of prostate cancer increases - but the tumors tend not to be lethal in the oldest age groups, explained Kavoussi. It's a cancer phenomenon that's not fully understood.
Two new studies into PSA (prostate-specific antigen) screening for prostate cancer this week raised more questions than they answered, according to the American Urological Association. Dr. Felix Badillo, chief of urology at St. Francis Hospital; Dr. Howard L. Adler, medical director of Stony Brook University's prostate care center; and Dr. Louis Kavoussi, chairman of urology at North Shore-LIJ Health System, offered clarity.
Does PSA screening reliably detect cancer?
Yes and no. It also spots inflammation in the prostate, which may sound a false alarm, a reason its reliability has been questioned. Even when cancer is present, Adler noted, a PSA also cannot help distinguish between aggressive and indolent tumors. Indolent cancers, slow-growing malignancies, are less likely to spread, requiring nothing more than "watchful waiting."
The new studies, one by Americans and the other by Europeans, drew different conclusions. The Americans found "no benefit" from PSA screening; the Europeans found a negligible benefit. Why the difference?
The studies involved different investigational techniques and different populations. The urological association issued a statement saying studies such as these are just part of the national discussion about PSA testing. An overwhelming body of evidence exists supporting the value of the test and the potential to save lives.
The studies suggest there is no "survival benefit" from routine screening. What does that mean?
When the PSA was developed in the 1980s, experts theorized a widespread mortality reduction, as was seen with mammography and breast cancer. That didn't happen. However, Badillo emphasized that the benefits of screening far outweigh the risks of forgoing the test, especially for men at risk because of family history or those between the ages of 50 and 75.
What about men who are older?
Men in their 80s and 90s can choose to be screened less frequently. As men age, the prevalence of prostate cancer increases - but the tumors tend not to be lethal in the oldest age groups, explained Kavoussi. It's a cancer phenomenon that's not fully understood.
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