Young men and prostate cancer screening

Just a week after the U.S. Preventive Services Task Force published new recommendations questioning the use of the PSA blood test in even more men, a new survey suggests that many young men are getting the test.

HealthDay News reports:

One in five men in their 40s has had a prostate-specific antigen (PSA) test in the past year, and young black men are more likely than young white men to have undergone the test, a new analysis shows.

The findings are published in the Sept. 15 issue of Cancer.

"That is a pretty amazing statistic, but not so hard to understand given the intense marketing of PSA testing for so many years," responded Dr. Steven Woloshin of Dartmouth Medical School and the VA Outcomes Group in an e-mail.

Woloshin reminds readers that we just don't know if screening does more good than harm.

He writes, "One thing that is often missing in the PSA discussion is the level of risk men face. This is of course crucial information: how else can you weigh the potential benefits and known harms if you don't know your chances to begin with? Unfortunately, the risk information isn't usually part of the discussion, or when it is it's usually given in aggregate terms. For example, you will read that 220,000 men were diagnosed last year or 28,000 died. Those numbers hide the fact that the risk changes dramatically with age; the numbers also do not provide context (ie, competing risks of death) for interpreting the risk."

To give people that context, Woloshin and colleagues Lisa Schwartz and Gilbert Welch recently published a paper in the Journal of the National Cancer Institute (JNCI). He explains, "The paper shows how we developed risk charts which present the 10-year chance of death from various causes (and all causes combined) at different ages. With regards to prostate cancer the charts show that for younger men there isn't a lot of risk to reduce with screening: out of 1000 men, less than 1 will die of prostate cancer in the next 10 years. Another way of saying that is more than 999 will NOT die of prostate cancer during this time."

You can see the risk charts yourself in the JNCI article.

Men are often told that this is just a simple blood test. Nothing could be further from the truth.

About this Entry

This page contains a single entry by Gary Schwitzer published on August 12, 2008 9:44 AM.

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