HCPLive Network

Alternative PSA Screening Strategies Could Reduce Harm

 
alternate PSA testing methods might be betterTUESDAY, Feb. 5 (HealthDay News) -- Compared with standard screening, alternative prostate-specific antigen (PSA) screening strategies could maintain good prostate cancer detection rates while reducing overdiagnoses and unnecessary biopsies, according to research published in the Feb. 5 issue of the Annals of Internal Medicine.

Roman Gulati, of the Fred Hutchinson Cancer Research Center in Seattle, and colleagues assessed the comparative effectiveness of alternative PSA screening strategies using a microsimulation model of prostate cancer incidence in a contemporary cohort of U.S. men. Thirty-five screening strategies were compared that varied by start and stop age, interval, and threshold for biopsy referral.

The researchers found that the risk for prostate cancer death was 2.86 percent without screening. The risk was reduced to 2.15 percent (with a 3.3 percent risk of overdiagnosis) with a reference strategy that screens men aged 50 to 74 years annually with a PSA threshold of 4 µg/L for biopsy referral. Use of a higher PSA threshold among older men was associated with a 2.23 percent risk of prostate cancer death and a decrease in the risk of overdiagnosis to 2.3 percent. A biennial screening strategy with longer screening intervals for men with low PSA levels was associated with a 2.27 percent risk of prostate cancer death and a 2.4 percent risk of overdiagnosis. In addition, this strategy correlated with a 59 percent reduction in total tests and a 50 percent reduction in false-positive results.

"If we recognize that realistic screening strategies must achieve an acceptable balance of benefits and harms as opposed to unconditionally maximizing benefits, we can improve on the effectiveness of existing PSA-based screening for prostate cancer," the authors write.
 

Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Copyright © 2013 HealthDay. All rights reserved.
 

Further Reading
Adolescent transgender patients face many challenges, as do the medical professionals who care for them. What is the best way to manage transgender youths? This is a complex question with answers that rely on a case-by-case, ethical approach
Monitoring patients’ own intestinal immune responses, researchers at Yale University have identified some of the bacterial culprits driving inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis.
A major demonstration project designed to gauge the effectiveness of bundled payments exposed the complications of implementing such a system. Officials say the 3-year study fizzled after participation waned and the number of applicable cases proved too few to be statistically relevant.
New research suggests that oral immunotherapy may trigger anaphylaxis in an unusually high percentage of asthmatic teenagers with high-risk food allergies who failed to adhere to their management plan.
For patients with stable coronary artery disease without clinical heart failure, ivabradine does not improve outcomes, according to a study published online Aug. 31 in the New England Journal of Medicine. The study was published to coincide with the annual European Society of Cardiology Congress, held from Aug. 30 to Sept. 3 in Barcelona, Spain.
The newest final rule for the Medicare and Medicaid EHR Incentive Programs provides more flexibility in how healthcare providers use certified electronic health record technology to meet meaningful use for an incentive reporting period in 2014.
For patients after an acute coronary syndrome event, darapladib inhibition of lipoprotein-associated phospholipase A2 does not reduce the risk of major coronary events, according to a study published online Aug. 31 in the Journal of the American Medical Association. The study was published to coincide with the annual European Society of Cardiology Congress, held from Aug. 30 to Sept. 3 in Barcelona, Spain.
More Reading