No More PSA Tests for Elderly, Feds Say

Even though prostate cancer is the second most common cause of cancer deaths in men, most prostate cancers grow so slowly that the patient often dies from some other cause. This fact has led some healthcare experts to question the value of the PSA test, the primary screening tool for prostate cancer, which more often than not produces a false positive. According to the National Cancer Institute, about 70% to 75% of men with elevated PSA levels are found not to have prostate cancer.

Even though prostate cancer is the second most common cause of cancer deaths in men, most prostate cancers grow so slowly that the patient often dies from some other cause. This fact has led some healthcare experts to question the value of the PSA test, the primary screening tool for prostate cancer, which more often than not produces a false positive. According to the National Cancer Institute, about 70% to 75% of men with elevated PSA levels are found not to have prostate cancer.

New guidelines from the U.S. Preventive Services Task Force reflect these facts in calling for an end to prostate cancer screening of men over the age of 75. The panel found that benefits of treating prostate cancer based on screening results for men in that age group are “small to none.” According to the task force report, those benefits are far outweighed by the negative side effects that treatment can cause, including impotence, incontinence, and bowel problems. The guidelines apply only to men who are asymptomatic—not to men who present with problems like painful urination or blood in the urine or semen.

Although the panel’s recommendations are at least partially based on the fact that prostate cancer treatments can be hard on older men, some doctors disagree with them. Some view the new guidelines as ageism, while others say they seem much like a form of cost control that might have been suggested by a health insurance company.