Prostate Cancer: Men Should Skip Common Blood Test, Panel Says

Men should not be screened for prostate cancer with a common blood test, a widely followed federal advisory panel recommended Monday.

But the report is not likely to quell a dispute about whether the test’s risks outweigh its potential benefits.

The US Preventive Services Task Force recommended a “D” grade for prostate-specific-antigen, or PSA, testing which has been widely used for almost two decades to screen men for prostate cancer.
Previously the task force had recommended against PSA testing for men aged 75 and older. Now the recommendation extends to all ages.

A “D” rating means “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits,” the group’s website says. It also is a recommendation “against the service.”

The Task Force report, published Monday online in Annals of Internal Medicine, said PSA screening detects many asymptomatic or slow-growing cases of cancer that will not cause men any problems in their lifetimes.

Treatments for those cancers can include surgery and radiation and can cause side effects such as impotence or urinary incontinence.

The task force said it conducted a review of clinical studies of PSA testing, including a large US study and a European one.

The US study did not find a mortality benefit. The task force said the European study suggested a small benefit of no more than one in 1,000 men screened.

“Many men are harmed by prostate cancer screening” with a PSA test, said Michael LeFevre, the task force’s co-chairman and a professor at the University of Missouri School of Medicine. “Very few will benefit.”

The task force is made up of 16 non-federal, primary-care providers who review preventative health services and make recommendations, primarily for primary-care doctors.

LeFevre said the task force recommended doctors could still offer the PSA test if men are informed about the risks and benefits.

The blood test is meant to detect a substance found normally in the prostate that is also made by cancer cells. Men with higher PSA scores typically have a higher risk of developing prostate cancer. But the test is not perfect, and in some cases follow-up biopsies find no cancer.

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