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.
“Our findings show a high rate of elderly and sometimes ill men being inappropriately screened for prostate cancer,” 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 benefitting the patient and paradoxically can cause more harm than good.”
Potential complications from the overuse of PSA screening include incontinence, impotence, and bowel dysfunction, according to researchers.
In this study, the researchers examined results from health surveys of randomly selected households conducted in 2000 and 2005 as part of the federal government-sponsored National Health Interview Survey. In addition to reviewing survey data, which included information on age, smoking, mass-body index, underlying medical conditions and other factors, the investigators calculated the estimated five-year life expectancy of each man over 40 who had received a PSA test. In all, 2,623 men ages 70 and older were included in the analysis.
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.
Researchers offered some possible explanations for the results, noting that screening rates may reflect how frequently men visit primary care physicians. For instance, older men who tend to have more health problems that require doctor visits may experience more frequent PSA testing than younger men.
The researchers suggested that physicians should be more selective in recommending PSA testing for older men, particularly those with a limited life expectancy.
The study appears in the current online issue of the Journal of Clinical Oncology.