Federal Panel Advises Doctors To End Prostate Tests on Elderly
August 5, 2008 10:25 a.m.
The U.S. Preventive Services Task Force, which made the recommendation, reported finding evidence that the benefits of treatment based on routine screening of this age group "are small to none." However, treatment often causes "moderate-to-substantial harms," including erectile dysfunction and bladder control and bowel problems, the task force said.
The new guidance is the first update by the task force on prostate cancer screening since 2002. The last report on the subject from this panel of experts, which sets the nation's primary care standards, concluded there was insufficient evidence to recommend prostate screening for men of all ages.
In recent years, there has been a growing debate about the value of the somewhat imprecise PSA test to detect cancer, as well as the value of treating most prostate cancers. A number of experts contend patients are being overtreated.
The federal task force reviewed past research
in reaching its conclusion and "could not find adequate proof
that early detection leads to fewer men dying of the disease,"
task force chairman Dr. Ned Calonge of
Prostate cancer is the most common cancer in American men -- about 220,000 cases will be diagnosed this year. It is the second leading cause of cancer deaths in men. But most tumors grow so slowly they never threaten lives. There is no accurate way to tell which tumors will.
Earlier this year, a study found that older men who already had early-stage prostate cancer were not taking a big risk by not treating it right away. The vast majority were alive 10 years later without significantly worrying symptoms or had died of other causes.
Prostate cancer treatments are tough, especially on older men. Some doctors instead recommend "watchful waiting" to monitor signs of the disease and treat only if they worsen, but smaller studies give conflicting views of the safety of that approach.
The new guidelines from the Preventive Services Task Force were published in this month's Annals of Internal Medicine.
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