Study: Older Men Over-Screened for Prostate Cancer

Dec 3 2003

WASHINGTON (Reuters) - Too many men over age 75 are being screened for prostate cancer (news - web sites), a common but slow-growing form of the disease, U.S. and Canadian researchers said on Tuesday.

 While doctors frequently recommend prostate-specific antigen (PSA) screening for men of 75 and older, it is generally agreed that the test does little good for them, the researchers said.

"It is somewhat surprising that so many physicians would suggest screening in elderly men when the benefits have not even been established among younger men," the authors wrote in the Dec. 3 issue of the Journal of the National Cancer Institute (news - web sites). The result could be unneeded expense and anxiety, they said.

PSA is a protein produced by prostate cells and over-produced by prostate tumor cells. High levels can indicate cancer, but it is not always clear just what level is dangerous.

Grace Lu-Yao of HealthStat in Princeton, New Jersey, Therese Stukel of the Institute for Clinical Evaluative Sciences in Toronto and Dr. Siu-Long Yao of the Cancer Institute of New Jersey reviewed the cases of 7,889 men of all ages taking part in a national health survey.

About 33 percent of those aged 75 or older said they had undergone a PSA screening test in the past year.

"Despite controversy regarding the efficacy of PSA screening, there has been general agreement that men aged 75 years or older (i.e., elderly men) should not be screened," the researchers wrote.

This is mainly because by age 75, men usually die of something other than prostate cancer.

"Rates of PSA screening among elderly men approached or exceeded rates found for existing established screening technologies such as fecal occult blood testing for colon cancer," the researchers added.

Colon cancer screening has clearly been shown to save lives.

Although 88 percent of the men said their doctors recommended screening, there was usually no pressing reason to do so, Yao's team reported.

"Known risk factors for prostate cancer, such as family history and race/ethnicity, were not associated with PSA screening among elderly men." they wrote.

Prostate cancer affects 189,000 U.S. men a year and kills more than 30,000.