Should Men Get PSA Tests to Screen for Prostate Cancer?

By MELINDA BECK, WSJ

One in six American men will be diagnosed with prostate cancer in their lifetimes. In most cases, the disease grows so slowly it doesn't cause problems. Yet some prostate cancers are fast-moving and lethal; about 28,000 U.S. men die every year because it wasn't detected and treated in time.

A test for prostate-specific antigen, or PSA, a protein made in the prostate, can give an early warning sign of cancer. But PSA tests also give many false alarms, prompting more than one million unnecessary biopsies every year. And when prostate cancer is found, more than 80% of men opt for surgery, radiation or hormone therapy that sometimes leaves them incontinent or impotent, even though their cancer probably wasn't life-threatening.

The U.S. Preventive Services Task Force, a nongovernmental panel of independent experts in prevention and evidence-based medicine, recently recommended doctors stop using PSA tests to screen men with no symptoms of prostate cancer. That prompted an outcry from some experts and advocacy groups concerned that prostate cancer would be missed, and many doctors have continued to order the tests.

Richard Ablin, a professor of pathology at University of Arizona College of Medicine, discovered the prostate-specific antigen in 1970, and for nearly as long, he has argued that it should not be used for routine screening. Oliver Sartor, medical director of Tulane Cancer Center in New Orleans, counters that while it isn't perfect, PSA testing has saved lives.

(More here.)