Earlier PSA Test Best Predicts Risk of Dying From Prostate Cancer: Study

WEDNESDAY May 18, 2011 -- The results of a first prostate-specific antigen (PSA) test for males between the ages of 44 and 50 can predict the risk of dying of prostate cancer within the next 25 to 30 years, according to a new study.

Researchers analyzed blood samples collected from 12,090 Swedish men between 1974 and 1986 when they were ages 44 to 50, samples from nearly 5,000 of the men six years later when they were ages 51 to 55, and samples from 1,167 men who were 60.

Men who had PSA levels below the median when they were 44 to 50 had a very low risk of prostate cancer death or metastases within 15 years. By age 60, for those men with PSA levels below the median, the risk of prostate cancer had decreased significantly to 0.5 percent.

Although current American Cancer Society guidelines suggest all but high-risk men should discuss screening with their doctor at age 50, the study authors say their results indicate earlier testing could reduce unnecessary screening later on.

The findings suggest that more than half of men could forego regular PSA testing after that time and have just three PSA tests in their lifetime, with the first one between the ages of 44 and 50, the second between ages 51 and 55, and -- if their PSA levels are still low -- the third and last at age 60, said the researchers at Memorial Sloan-Kettering Cancer Center in New York.

However, men with higher PSA levels between the ages of 44 and 50 are at high risk for aggressive prostate cancer and should continue to undergo PSA tests and screening as necessary, the researchers added.

The study was slated to be presented to journalists today May 18 as part of the annual meeting of the American Society of Clinical Oncology.

"This research helps us distinguish between those men who may benefit from regular PSA screening for prostate cancer and those men who may not need to be screened so frequently," lead author Dr. Hans Lilja, a clinical chemist with joint appointments in the Departments of Laboratory Medicine, Surgery, and Medicine, said in a Memorial Sloan-Kettering news release.

"Instead of testing all men each year or every two years, screening and surveillance efforts can be focused on early detection of prostate cancer in those men who are found to be at high risk of death from the disease."

PSA testing is recommended for early detection of prostate cancer but is associated with a high rate of overdiagnosis and overtreatment, which is a concern because prostate cancer treatment can lead to debilitating erectile and urinary problems.

Because the study is being presented at a medical meeting, its results should be considered preliminary until published in a peer-reviewed journal.

More information

The American Cancer Society has more about prostate cancer.

Posted: May 2011


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