More Men Diagnosed with Advanced Prostate Cancer as PSA Screening Declines
Prostate-specific antigen (PSA) screening, a blood test to detect cancer in men, has decreased significantly over the past several years. As a result, more men are being diagnosed with advanced prostate cancer, which often has a poorer prognosis than more localized disease.
Whats behind the Decrease in PSA Screening?
There are three main reasons for the decrease in PSA screening:
- The U.S. Preventive Services Task Force (USPSTF) issued guidelines that recommend against PSA screening in men between the ages of 55 and 69 in 2008, due to the potential harms of testing such as overdiagnosis, false positives with resulting anxiety, unnecessary treatments and complications.
- Costs associated with PSA testing, biopsies and other follow-up procedures make the testing less appealing to both medical professionals and patients.
- Improved treatments for advanced prostate cancers, including radiation and hormone
therapy, have lowered the urgency for early testing.
The Impact of Lower Rates of PSA Screening
Due to the lower rates of PSA screening, more men are being diagnosed with prostate cancer in advanced stages. Prostate cancer is the second leading cause of cancer death in men in the United States and advanced prostate cancer has a poorer prognosis than localized disease.
An analysis of the National Cancer Database revealed that since 2000, the rate of men being diagnosed with advanced prostate cancer has increased. In men aged 65 and over, for example, advanced prostate cancer diagnoses increased by 11%, while localized prostate cancer diagnoses decreased by 15%.
The Benefits of PSA Screening
Prostate cancer is a highly treatable disease when it is found early, and PSA screening remains a vital tool in detecting prostate cancer at an early stage. In a 2017 article published in Cancer, the authors advocate for a more individualized approach to PSA screening, taking into account patient risk factors and preferences.
PSA screening is still beneficial to many men, including those with a family history of prostate cancer, African-American race, and an age of 50 or older. The American Cancer Society recommends PSA screening annually starting at age 50 for men of average risk and earlier for those of higher risk.
Conclusion
The lower rates of PSA screening are resulting in more men being diagnosed with advanced prostate cancer, which often has a poorer prognosis than localized disease. Men should speak to their doctors about their own individual risk factors and preferences to determine if they should proceed with PSA screening.
Recent studies have demonstrated that the declining use of prostate-specific antigen (PSA) screenings for detecting prostate cancer has led to an alarming rise in the number of cases of advanced prostate cancer among men.
The findings, published in the journal JAMA Oncology, suggest that as fewer men are screened for prostate cancer, there is an increasing number of cases in which the cancer has already spread to other parts of the body or recurred.
For the study, researchers analyzed data from close to 750,000 men in the U.S. ages 50 and older, over a ten-year period. The data showed that between 2011 and 2018, the number of cases of advanced prostate cancer increased by 17.5%, while the number of all cases of prostate cancer decreased by 8%.
The study also suggested that in recent years, more and more men are opting out of prostate cancer screening through PSA testing, either because of a lack of awareness or hesitance due to the potential discomfort and risks associated with the exam.
In light of these findings, experts caution that the importance of routine prostate cancer screenings should not be understated. Prostate cancer is the second most commonly diagnosed cancer for men in the United States, and experts agree that the only effective way to treat it is with early detection.
According to experts, early detection and detection of localized cancer, which is the earliest form of prostate cancer, is necessary to promote positive outcomes and quality of life in those affected. As such, it is important that men discuss the benefits and risks of the PSA test with their healthcare provider and make an informed decision about whether to be screened.
The results of this study demonstrate the importance of regular prostate cancer testing, and the potential harms posed by declining screening rates. It is vital that men understand the benefits of early detection and make an informed decision about their healthcare.