From across the Pond: PSA Testing under Review

Source: BBC Health; British Medical Journal

A recent Swedish study (Yes, where the candy fish come from) comparing PSA (Prostate Specific Antigent) Test results of 540 men before they were eventually diagnosed with prostate cancer and 1,000 healthy men failed to determine the point where a PSA Test was a diagnostic predictor of prostate cancer.

What does that mean?  Okay.  Very low concentrations of PSA (less than 1 ng.ml) basically ruled out a future diagnosis of prostate cancer.  The problem lies in setting the upper ranges. Currently those men with a PSA of 3 ng/ml who are aged 50-59 are candidates for urological follow up.  Men 60 and over with a PSA of 5 ng/ml are also.  But beyond that there is still not enough information.  A viable concern is that over-diagnosis might lead to over-treatment with the attendant side effects of impotence and incontinence.  (Aren’t you glad you don’t have a prostate ladies?)

Prostate cancer has risen to the 2nd most common cause of cancer related deaths in the UK. Rates are somewhat lower in the US with an average mortality age of 80.  Prostate cancer is typically “survivable” if diagnosed and treated early.  Oddly the UK approach of less PSA Testing seems to be the opposite of that in the States.  Time will truly tell on this one.

Posted by David Marc Schwadron, Esquire