Physicians Too Aggressive in Ordering Prostate Screenings

May 17, 2011
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Many elderly men may be undergoing unnecessary—and perhaps complicating—prostate cancer screenings, according to a study on the use of prostate-specific antigen (PSA)-based screening methods in the United States. Researchers reported that nearly half of men in their seventies underwent PSA screening in the past year, almost double the screening rate of men in their early fifties.

Many elderly men may be undergoing unnecessary—and perhaps complicating—prostate cancer screenings, according to a study on the use of prostate-specific antigen (PSA)-based screening methods in the United States. Researchers reported that nearly half of men in their seventies underwent PSA screening in the past year, almost double the screening rate of men in their early fifties. Men aged 85 and older were screened just as often as men in their early fifties.

Researchers said in a release: “We’re concerned these screenings may prompt cancer treatment among elderly men who ultimately have a very low likelihood of benefiting the patient and paradoxically can cause more harm than good.”

Potential complications include incontinence, impotence, and bowel dysfunction, according to researchers.
  • The PSA screening rate was 24% in men ages 50 to 54, increasing with age until a peak of 45.5% in ages 70 to 74.
     
  • Screening rates then declined with age, with 24.6% of men 85 or older reporting being screened.
The researchers suggested that physicians should be more selective in recommending PSA testing for older men, particularly those with a limited life expectancy.

I agree with the researchers that the side effects of the test, especially if there is no cancer, out weigh the benefit. Though I also sense some age bias going on as well. What is not said is what they are thinking, essentially these people are going to die soon anyway so why go through costly and needless treatments. That is fine until it is your family member or yourself facing a diagnosis.