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A group of experts recommended not to perform a routine blood screening for prostate cancer in a report published Wednesday in the BMJ.
The panel, composed of general practitioners, urologists, methodologists and patients, cited five clinical trials that evaluated the use of a blood test for the specific antigen of prostate (PSA) in screening for prostate cancer. According to the study, the use of this screening test resulted in no significant decrease in the total number of patient deaths.
Prostate cancer screening has been a controversial topic in the field of medicine. Screening for PSA has definitely led to an increase in the detection of prostate cancer. "The problem is that the PSA test, the only test currently available, has a high incidence of false positive and false negative results, and many cancers detected by PSA are indolent and would not cause any harm to the patient," said Dr. Martin Roland, professor emeritus of research on health services at the University of Cambridge, said in an editorial. Current tests do not reliably identify aggressive cancers and these can kill.
New methods of prostate cancer management, including prostate MRI and MRI-guided biopsies, are not widely available for the general population, despite promising results.
False positive PSA results lead to unnecessary treatments and the side effects of treatment can be significant. Biopsies and surgeries can not only cause an infection, but can also lead to urinary incontinence and erectile dysfunction. After surgery, incontinence was observed in up to 17% of patients and erectile dysfunction in 83% of cases.
The recommendations follow recent changes made to the recommendations of the US Task Force on Preventive Services in May 2018. They now promote PSA screening as an individual decision. Do not recommend screening in the general population either. The panel warned, however, that some groups, such as those with a family history of prostate cancer, might consider PSA testing.
Dr. Jonathan Steinman is a physician and author in radiology with the ABC News Medical Unit.
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