Panel Recommends No Prostate Screening for Healthy Men



A key federal advisory panel is poised to recommend that healthy men shouldn't be screened with a widely used blood test for prostate cancer, indicating that the test offers more harm than benefit, The Wall Street Journal reported Friday.

The US Preventive Services Task Force will recommend a "D" rating for prostate specific antigen, or PSA, testing, said a person familiar with the draft document. A "D" rating means "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," according to the group's website. It also is a recommendation to "discourage use" of test or treatment.

The task force, an influential group whose recommendations can influence coverage decisions by the federal Medicare program and other insurers, is set to make its proposal Tuesday.

The scientific findings behind the recommendation are scheduled to be published Monday by the Annals of Internal Medicine. A copy of the paper was obtained by the newsletter Cancer Letter, which posted the paper on its website Thursday night.

The paper concluded that after about 10 years, PSA screening "results in small or no reduction" in death from prostate cancer but is "associated with harms," including biopsies, other tests and treatments, "some of which may be unnecessary."

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Virginia Moyer, who chairs the task force, declined to comment on what the updated advisory would be. She noted that the current guidance is that the evidence is insufficient to recommend for or against screening in men younger than 75.

"This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime," Moyer told The New York Times Thursday. "We need to find one that does."

The new report is the latest in a long-running controversy over the value of PSA screening. Advocates say the test, when given regularly to men age 50 and over, facilitates the discovery of the cancer at an early stage, improving the chances of successful treatment. Critics say the test has a significant rate of false positives -- apparent detection of cancer that isn't confirmed with further tests -- or that it identifies so-called indolent tumors that are ultimately of little health consequence.

Because such interventions can lead to infections, impotence and incontinence, critics say the risks of testing often outweigh the benefit.

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland. PSA tests measure the levels of PSA in a man's blood, with higher levels a marker that prostate cancer or benign conditions may be present, the US National Cancer Institute says.

More than 200,000 American men are diagnosed with prostate cancer each year.

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