Caregiver's Home Companion Caring for someone who has trouble hearing the phone?
 HOME PAGE  SEARCH Go

Posted: September 03, 2008

Men Over Age 75 Should Not Be Screened for Prostate Cancer: Panel

 

Men age 75 and older should not be screened for prostate cancer, and younger men should discuss the benefits and harms of the prostate-specific antigen (PSA) test with their clinicians before being tested, according to a government panel of medical experts in disease prevention and treatment.

 

advertisement
Drive Longer, Stay Independent
The U.S. Preventive Services Task Force found evidence that screening for prostate cancer provided few health benefits but led to substantial physical harms and some psychological harm in older men, which they defined as those age 75 and older. The recommendation and accompanying evidence were published in the journal Annals of Internal Medicine.

 

In men younger than 75, the task force concluded that current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening. An estimated 218,890 U.S. men were diagnosed with prostate cancer in 2007, and one in six men will be diagnosed in his lifetime, the experts noted.

 

Screening for prostate cancer is most often performed using PSA tests and digital rectal exams, with the PSA test more likely to detect prostate cancer than the digital rectal exam. However, prostate cancers that are found with a PSA test take years to affect health; most prostate cancers that grow serious enough to cause death take more than 10 years to do so.

 

The panel concluded, in forming their recommendation, that since a 75-year-old man has an average life expectancy of about 10 years and is more likely to die from other causes such as heart disease or stroke, prostate cancer screening is unlikely to help men over 75 live longer.

 

For the same reasons, men younger than 75 with chronic medical problems and a life expectancy of fewer than 10 years are also unlikely to benefit from screening. There is also harm associated with prostate cancer screening, which include biopsies, unnecessary treatment and false-positive results that may lead to anxiety, the panel noted. Complications often result from treating prostate cancer and may include urinary incontinence and impotence. These slow-growing cancers may never have affected a patient’s health or well-being had they not been detected by screening.

 

“Because many prostate cancers grow slowly, early detection may not benefit a patient’s health and in some cases may even cause harm,” said the task force chairman Dr. Ned Calonge, who is also chief medical officer for the Colorado Department of Public Health and Environment. “We encourage men younger than 75 to discuss with their clinicians the potential -- but uncertain -- benefits and the possible harms of getting the PSA test before they decide to be screened.”

 

Current data show that one-third of all men in the United States over 75 are receiving PSA testing. Although most major medical organizations suggest that prostate cancer screening be discontinued in men with a life expectancy of fewer than 10 years, the task force is the first group to define an explicit age cutoff above which screening is likely to be ineffective or harmful. The results of two ongoing clinical trials -- the National Cancer Institute’s Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the European Study of Screening for Prostate Cancer -- should help to clarify the potential benefits of screening in men under the age of 75, the panel reported.

 

The government task force is the leading independent panel of experts in prevention and primary care in the United States. The group, which is supported by AHRQ, conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Many authorities believe the task force’s recommendations are the gold standard for clinical preventive services.

Email or share this story Bookmark and Share

Search CaregiversHome
Find with keyword(s):

Enter a keyword or phrase to search CaregiversHome's archives for related news topics, the latest news stories, timely times, and reference articles.

© 2008 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

_____

View The Caregiver's Hotline in which this article first appeared

Back to Top

Privacy Statement Contact Us Site Map Products & Services Our Partners Advertise
© Copyright 2003-2020. Pederson Publishing, Inc. All rights reserved.