An influental doctors group is backing off its call for annual prostate cancer screening tests after age 50.
"Many men do not need yearly screening," but each man's risk should be individually assessed, said Dr. Peter Carroll, who helped write new American Urological Association guidelines that will be released today.
The new stance from the AUA brings it more in line with advice from other experts, who say annual screenings lead to unnecessary biopsies and treatment with little proof that they save lives. Screening involves a physical exam and a blood test for the level of prostate-specific antigen.
The urology group's new advice says men should get a baseline PSA test at age 40, and followups at intervals based on each man's situation. A high PSA at age 40 can indicate a higher risk of prostate cancer, said Carroll, a urologist at the University of California at San Francisco.
Doing a baseline test "makes a lot of sense to me," said Dr. Eric Klein, prostate cancer chief at the Cleveland Clinic.
Others disagreed.
There is no proof that a baseline test will save lives, said Dr. Barnett Kramer, a National Institutes of Health scientist.
"The same issue of harm comes up - overdiagnosis. A baseline PSA, just like regular PSA screening, can lead to the diagnosis of cancers that would not have harmed a man had they not been detected," Kramer said.
Prostate cancer is the most common nonskin cancer in American men. There were an estimated 186,000 new cases and 28,660 deaths from it last year.
Despite its name, PSA isn't very specific. It can rise for many reasons besides cancer, such as the use of certain medicines, the normal enlargement of the gland as men age - even things like a hard bike ride or recent sex.
THE ASSOCIATED PRESS / Monday, April 27th 2009, 4:00 AM
Posted by Scott W. Yates, MD, MBA, MS, FACP
