PSA Screening Can Lower Mortality

Screening of prostate cancer by evaluation of PSA levels (prostatic specific antigen) can lower mortality due to prostate cancer according to a new research. This finding is important as it goes against the current prostate cancer guidelines devised by USPSTF (or United States Preventive Services Task Force). Current guidelines suggest that PSA test should not be used routinely for prostate cancer screening as there is little evidence that it might reduce the risk of cancer-related mortality. The lead investigator of this study, Ruth Etzioni, suggested that now is the time to reevaluate and revise the guidelines for PSA screening.

The results of this study are published in the peer-reviewed journal Annals of Internal Medicine.

PSA Screening – What Should You Know About It?

Prostate malignancy is one of the most frequently reported cancer that is associated with high morbidity and mortality. The average age at diagnosis of prostate cancer in US is 66 years. In the United States, PSA analysis is the most popular test for the detection of prostate malignancy and involves estimation of prostate-specific antigen in the serum. PSA is a protein that is secreted by abnormal cancerous cells of prostate gland.

According to the guidelines presented by American Cancer Society, most normal men have low PSA levels in their serum (under 4 nanograms per milliliter). Moderately high PSA levels are suggestive of malignancy for example PSA levels between 4 and 10 nanograms per milliliter are associated with 25% risk of prostate malignancy. Likewise, high PSA levels of over 10 nanograms per milliliter are associated with malignancy in about 50% cases. In other words, oneof 2 men who have higher than PSA levels higher than 10 nanograms per milliliter are diagnosed with prostate cancer.

It is noteworthy that abnormal PSA levels are not always suggestive of cancer; for example, certain drugs, profound stress and longstanding history of urinary tract infections are also associated with abnormally high PSA levels. In fact, United States Preventive Services Task Force believes that unnecessary PSA screening adds to the stress and over-treatment, consequently leading to even higher PSA levels without malignancy. USPSTF also suggests that PSA analysis does not offer any benefit in terms of improved fertility.

Verdict Of PSA Screening

Ruth Etzioni and her team suggests that USPSTF should revise the PSA screening recommendation to ensure early detection and prompt management of prostate cancer. Several newer studies also suggested that PSA screening is associated with a better survival rate and lower mortality.

References

• Oeffinger, K. C., Fontham, E. T., Etzioni, R., Herzig, A., Michaelson, J. S., Shih, Y. C. T., ... & Wolf, A. M. (2015). Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society. Jama, 314(15), 1599-1614.
• Gulati, R., Heijnsdijk, E. A. M., Pinsky, P. F., Moss, S. M., Qiu, S., de Carvalho, T. M., ... & Roobol, M. J. (2017). Different Effects of Screening on Prostate Cancer Death in Two Trials.