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Title: Prostate Cancer Screening Not Recommended for Men Older Than 75 Years
URL: http://www.pslgroup.com/dg/2271DE.htm
Doctor's Guide
August 5, 2008

ROCKVILLE, Md -- August 5, 2008 -- The US Preventive Services Task Force updated its recommendations for prostate cancer screening to include that men aged 75 years and older should not be screened. The recommendations appear in the August 5 issue of the Annals of Internal Medicine.

The update also recommends that younger men should discuss the benefits and harms of the prostate-specific antigen (PSA) test with their clinicians before being tested.

The Task Force found evidence that screening for prostate cancer provided few health benefits, but led to substantial physical harms and some psychological harms in men aged 75 years and older.

In men aged younger than 75 years, the Task Force concluded that current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.

Since a man aged 75 years 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 aged younger than 75 years with chronic medical problems and a life expectancy of fewer than 10 years are also unlikely to benefit from screening.

There are also harms associated with prostate cancer screening, which include biopsies, unnecessary treatment and false-positive results that may lead to anxiety. 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 Ned Calonge, MD, Preventive Services Task Force, Rockville, Maryland, and Colorado Department of Public Health and Environment, Denver, Colorado.

"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."

The results of 2 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 aged younger than 75 years.


SOURCE: American College of Physicians

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