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PSA Testing Gets A Boost

An important doctors' group is breaking with other leading medical experts and continuing to recommend PSA testing for prostate cancer. Not only that, the group is actually lowering the age at which it recommends men start getting the test.

PSA testing has become one of the most controversial issues in health. Many men routinely undergo the blood test to try to spot prostate cancer early. There's no question the screening can do that, but many doctors have begun to challenge routine PSA testing because it often leads to unnecessary biopsies and treatment for a cancer that may never be life-threatening. Prostate cancer is often so slow growing that it never actually causes problems. Two major studies released last month fueled doubts about PSA testing when they failed to find clear evidence it reduced the chances of dying from prostate cancer.

But the American Urological Association begs to differ in its updated recommendations on PSA testing released Monday. The guidelines say PSA testing can be very useful in spotting cancer early and helping men and their doctors make decisions. The guidelines lower the age that it says doctors should offer it to men from 50 to 40.

The key, the guidelines say, is how the results are used. For example, the other big change the guidelines recommend is how the results are interpreted. Instead of doing a biopsy simply when the PSA level goes above a certain level, the guidelines say the PSA "velocity" is more important. That's how fast the PSA level is rising. If a man's PSA rises very quickly over a short period of time, the guidelines say, that's when a biopsy may be necessary.

By Rob Stein  |  April 30, 2009; 7:00 AM ET
Categories:  Cancer  
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I'm glad to see this update on the topic. Six weeks ago my doctor spotted a PSA change from .7 to 1.4 in only two months. Even though both numbers are well within the "normal" range, he ordered a biopsy that found cancer serious enough to warrant a rapid response. At age 54, I'm very glad the PSA levels were being checked.

Posted by: AndrewfromNH | April 30, 2009 1:47 PM | Report abuse

I would be dead now if I had not had my PSA tested 14 years ago. My prostate cancer was aggressive. Every male should be regularly tested.

Posted by: 09876543212 | April 30, 2009 1:54 PM | Report abuse

Please note that the "boost" in this article is not the result of a study which evaluates the relative effectiveness of PSA screening (i.e. does it actually make you live any longer) Instead, it is just another set of guidelines, based on no new information, from a group which obviously has an interest in treating as many cases of prostate cancer as possible. This is like having the price of a stock rise when an analyst issues a buy recommendation -- nothing of substance has actually happened here.

The results of the two recent studies are clear: PSA screening DOES NOT IMPROVE YOUR LIFE EXPECTANCY! In other words, for every man whose life was saved by early detection of prostate cancer, there are one or more men whose lives were unnecessarily shortened by overtreatment.

The bottom line: avoid diagnostic tests for conditions for which you have no symptoms or family history. Research shows that you will live just as long as the sucker who spends his days in the doctor's office, and your life will be happier as well. Personally I'd rather take my chances with prostate cancer than with the huge floating carnival which is the American medical system today...

Posted by: jerkhoff | April 30, 2009 2:35 PM | Report abuse

There is more to life than "life expectancy". Those contemplating not getting baseline and periodic PSA tests, please read about what happens to men when cancer leaves their prostate and can no longer by eliminated. Yes there are treatments that will keep you alive but continually fighting off a spreading cancer is not a pleasant life. PSA testing can help you avoid that possibility. Read the articles by Dr. Catalona, and Dr. Walsh at

Posted by: rleesmith18 | April 30, 2009 11:36 PM | Report abuse

The AUA's decision on PSA is unethical. The results of the PLCO trial at the very least recommends careful counseling of patients before PSA testing(as recommended by the USPSTF), explaining the pros and cons of the procedure. Every urologist was eagerly awaiting the results of the first clinical trial performed in the U.S. to determine whether testing assymptomatic men with PSA for prostate cancer reduced deaths from the cancer. The PLCO trial clearly showed that it did not. A similar European trial showed that over 1000 men had to be screened and 48 men had to be treated for prostate cancer (yes, an unnecessary prostatectomy) to save one man from dying from the disease. Up until this trial, nearly all European trials have been dismissed by American urologists as being "inferior". This was because the Americans did not like the conclusions drawn by the European studies-testing assymptomatic men did not help save lives. What the European trial showed is that PSA testing led to overdiagnosis (by 50%) and overtreatment of prostate cancer. The Europeans haven't changed their stance on screening. They still believe that screening comes at too high a cost (we're not talking money, but human welfare) Hey docs, you're treading down a slippery slope in what appears to be an attempt to save your high income. This is not science but faith. For more on these and other topics please visit

Posted by: Jeff37 | May 1, 2009 10:56 AM | Report abuse

Doctors make a lot of work to support such measures. Men usually do not trust the traditional tests, the ease and versatility of the PSA test is the best and avoid the proliferation of prostate cancer...
Herbal Remedies

Posted by: HerbalRemedies | May 2, 2009 4:02 PM | Report abuse

What we see here is an obvious conflict of interest. If men followed the science of the two PSA studies just released, they would walk away from the cash cow that urologists have provided for themselves. I agree with the poster above that it is immoral to have the research in hand, but then dismiss it for economic reasons.

Posted by: george11 | May 6, 2009 4:40 PM | Report abuse

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