Thursday, March 04, 2010


Thats stands for Prostate-Specific Antigens rather than Public Service Announcements. PSA screenings are a common test performed in the US, whose efficacy is still disputed. Our local paper has a good article covering some of the issues.
The American Cancer Society is urging doctors to make clearer to men that the test used to screen for prostate cancer has limits and may lead to unnecessary treatments that do more harm than good.

American men long have been urged to have prostate cancer screenings, but over time studies have suggested most cancers found are so slow-growing that most men could have avoided treatments that can lead to incontinence or impotence.
New Guidelines include:
Doctors should discuss the pros and cons of testing with their patients, including giving them written information or videos that discuss the likelihood of false test results and the side effects of treatment; stop giving the rectal exam as a standard screening tool because it has not clearly shown a benefit, though it can remain an option; and use past PSA readings to determine how often follow-up tests are needed and to guide conversations about treatment.
You might want to bring these into to the doctor. It will be your get out of jail free card should you see him go for the rubber gloves and vaseline. Interestingly there is some evidence that PSA tests have had some sort of effect on mortality. Looking at the US and UK this study, came to the following conclusions:
The striking decline in prostate-cancer mortality in the USA compared with the UK in 1994–2004 coincided with much higher uptake of PSA screening in the USA. Explanations for the different trends in mortality include the possibility of an early effect of initial screening rounds on men with more aggressive asymptomatic disease in the USA, different approaches to treatment in the two countries, and bias related to the misattribution of cause of death. Speculation over the role of screening will continue until evidence from randomised controlled trials is published.

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