I am aware that a lot of men enquire about PSA blood tests for prostate cancer. The jury is still out as to how effective this testing is for men without any symptoms or history of prostate cancer. A large trial in the USA showed no reduction in deaths from prostate cancer and there is ongoing research in Europe along similar lines.
The difficulties are that not all men with prostate cancer have high PSA levels. 66% of men with high PSA levels do not have prostate cancer (and may need further invasive tests to prove this) and there is uncertainty about whether treating all early prostate cancer will make a difference to life expectancy.
To save one life, we would have to test 1410 men, and treat 48 of them for prostate cancer (often not a pleasant experience on its own). As things stand, the national recommendation is that PSA should not be used as a screening test.
We will discuss this with you if you would like a PSA test as I am aware that a lot of people were having annual tests as a screen. The main aim is to prevent false reassurances and also prevent further harm to patients from unnecessary testing.
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Whilst I appreciate that a negative PSA may give false reassurance, I don't quite follow why there may be 'further harm to patients from unnecessary testing.'
ReplyDeleteA raised PSA would often require a prostate biopsy procedure which is fairly unpleasant and carries a risk of infection and bleeding. Other procedures include a resection of the prostate which can lead to incontinence and impotence. If a lot of men are getting false positives on the PSA test, then they are at risk from side effects of the further tests as well as the psychological distress of worrying about a potential cancer.
ReplyDeleteOuch. I understand now.
ReplyDeleteThanks for the helpful reply.