With Fewer PSA Tests, Rate of Advanced Prostate Cancers Rose

WEDNESDAY, March 16, 2022 (HealthDay News).

Since routine prostate-specific antigen (PSA) screening tests are no longer recommended. A new study has found that there has been an alarming rise in advanced prostate cancer cases in the United States. Tests measure the amount of PSA in the blood. And elevated levels may signal the presence of prostate cancer. Routine PSA screening began in the United States nearly three decades ago. Resulting in a decline in both advanced prostate cancer cases and prostate cancer deaths. However, routine PSA screenings also increase the risk of overdiagnosis. And overtreatment of low-risk prostate cancer.

This prompted the US Preventive Services Task Force in 2008. To make a recommendation against routine PSA screening in men over 75 years of age, and again in 2012. recommendation against such screening for all men. This recommendation was modified again in 2018 to say. Men aged 55-69 should discuss PSA screening with their doctors if they so desire.

To assess the impact of abbreviated screening,

Researchers at the University of Southern California analyzed data from more than 836,000 U.S. men aged 45. And older who were diagnosed with invasive prostate cancer from 2004 to 2018. Of these cases, advanced cancer has been reported in more than 26,600 men aged 45 to 74. And more than 20,500 men aged 75 and older. Among men aged 45 to 74, the incidence of advanced prostate cancer remained stable from 2004 to 2010 but then increased by 41% from 2010 to 2018. For men 75 and older, the incidence rate declined from 2004 to 2011, but then increased by 43% from 2011 to 2018. In both age groups, growth was in all races.

The findings were published on March 14 in the journal JAMA open network.

“This study is the first to document the ongoing growth of metastatic [advanced] prostate cancer using the most up-to-date population dataset,” said study co-author Dr. Mihir Desai, professor of clinical urology at the Medical School. The Keck University of Southern California.”The discovery has important implications for men because prostate cancer found at an early stage, usually through screening, is highly treatable and often curable,” Desai added in a university press release. “These data are very important because they point to the need for constant reassessment of the impact of political decisions,” said study co-author Dr. Giovanni Caccamani, assistant professor of research urology and radiology at Keck. “Otherwise, we may see continued growth in metastatic prostate cancer.”

The researchers noted that the reasons for stopping routine PSA screenings may be outdated.

Co-author Dr. Inderbeer Gill, chief of the department of urology and executive director of the USC Institute of Urology, noted that urology centers are finding new ways to improve patient outcomes. “Better strategies, including biomarkers and magnetic resonance imaging. [MRIs]have already increased detection of clinically significant cancers, while active surveillance is increasingly being used for low- and favorable-moderate-risk diseases, reducing the risk of overtreatment,” Gill said in a press release.

More information

More information about prostate cancer screening can be found at the US National Cancer Institute.

SOURCE: University of Southern California press release March 14, 2022

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