Discoverer: PSA test can't diagnose prostate cancer

Got something to publish? Send it to foodconsumer.org@gmail.com?

The discoverer of the routine PSA screening test said, in a commentary on the New York Times, that his method should not be used to screen prostate cancer for healthy men who have no family history of the disease because first, it cannot detect prostate cancer and second, it cannot reveal whether a prostate cancer is lethal or benign.

Dr. Richard Ablin of the University of Arizona called use of his prostate cancer screening method "a hugely expensive public health disaster" which costs the U.S. at least $3 billion each year paid mostly by Medicare and the Veterans Administration.

Dr. Ablin said, "As I've been trying to make clear for many years now, PSA testing can't detect prostate cancer" and "the test simply reveals how much of the prostate antigen a man has in his blood."

The level of PSA does not tell doctors whether their patients have prostate cancer or not.  Doctors believe high levels of PSA are indicative of prostate cancer, but in reality, that is not always true because normally enlarged prostate glands in older men also produce high levels of the antigen.  Because of this, the PSA testing can yield false positive results which in turn would lead to harmful biopsy, surgery and radiation, which in many cases are not necessary and harm the patients.

Dr. Ablin was cited as saying his method should be used in men who have received treatment for prostate cancer and those who have a family history of the disease.

Dr. Ablin suggested that the medical push for massive prostate cancer screening is profit-driven.  "Testing should absolutely not be deployed to screen the entire population of men over the age of 50, the outcome pushed by those who stand to profit," Ablin was quoted as writing.

On March 3, the American Cancer Society, an organization full of physicians, issued new guidelines to advise doctors to talk to their patients about the risks and benefits from the prostate cancer screening.  Doctors, in many cases, fail to discuss the risks with their patients.

The ACS - which many critics say are too cozy with the medical circle - adopted the guidelines because two recent major studies, one in North America and the other in Europe, have found that PSA tests and digital rectal exam do not help reduce mortality or death risk.

The National Cancer Institute says there is actually no standard or routine screening test for prostate cancer and all screening tests carry risks.  Studies have shown finding prostate cancer may not improve health or help a man live longer; tests may lead to unnecessary surgery like biopsy or treatment; tests may result in false negative results, and false-positive results and both can harm the patients.

The ACS says that if you expect to live 10 years or less, don't bother to get prostate cancer screening because you are more likely to die from other health conditions. That is why previous studies suggest men over 70 should not get prostate cancer screening.

The ACS still recommends that "men with no symptoms of prostate cancer who are in relatively good health and can expect to live at least 10 more years have the opportunity to make an informed decision with their doctor about screening after learning about the uncertainties, risks, and potential benefits associated with prostate cancer screening." and the talks should start at the age of 50 years.

The ACS also say that men at high risk such as African-American men and men who have a male in his family diagnosed with prostate cancer before age 65 should begin talking to their doctors at the age 45. If multiple family members have been diagnosed with the disease, then they need to be screened starting at age 40.

Prostate cancer is diagnosed in about 180,000 men in the United States and roughly 35,000 men die from the disease annually in the country.

By David Liu and editing by Denise Reynolds

(The article may contain content from articles by other foodconsumer.org writers)