Men in their early 40s benefit more from prostate screenings than men in their 50s to 60s, according to a new study.
Researchers recommended that men get a baseline prostate-specific antigen test in their early 40s because new studies have shown that higher levels at this age predicted the risk of prostate cancer in later years significantly more than men with low PSA levels in their early 40s, according to a statement released on Friday.
"Now, based on our updated results with nearly all men followed for 10 years and more than half for 13 years, we are learning that only the youngest men — those with the longest life expectancy — are apt to benefit from screening. We need to modify our current practices and stop screening elderly men and those with a limited life expectancy," said Gerald Andriole, chief urologic surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in a statement.
"Instead, we need to take a more targeted approach and selectively screen men who are young and healthy and particularly those at high risk for prostate cancer, including African-Americans and those with a family history of the disease," Andriole said.
Researchers said that their data confirmed that it was unnecessary for most men to be screened annually for prostate cancer because the “large majority” of the cancers researchers found in their follow-up study of more than 76,000 men showed that they were slow-growing tumors that were unlikely to be deadly.
Andriole said that researchers had detected 12 percent more prostate tumors among men screened annually compared to those who only received routine care, but the deaths from prostate cancer did not differ significantly between these two groups.
Researchers indicated that annual screening tests for prostate cancer for men in their 50s or 60s did not reduce deaths like researchers had previously predicted, and men diagnosed with prostate cancer who also had a history of heart attacks, strokes, diabetes, cancer or lung and liver disease were significantly more likely to die from reasons other than prostate cancer.
"Mass screening of all men on the basis of age alone is not the way to go, but screening can still be useful in select men," said Andriole.
"We have to take a more nuanced approach to determine which men should be screened with PSA in the first place, how frequently they should be tested, the PSA level at which they should be biopsied and whether their cancer warrants aggressive therapy," in said.
He noted that widespread testing leads to many men being over0diagnosed and over-treated with surgery and radiation therapy, and said that the possible side effects of these treatments can lead to incontinence and impotence.
The study is published in the Journal of the National Cancer Institute, and researchers noted that the new study comes after a recent draft recommendation by the U.S. Preventative Services Task Force calling for an end to routine PSA testing for health men age 50 and older.