Prostate cancer

PSA testing remains viable for men at high risk

 
 
Gerald L. Andriole, MD

Gerald L. Andriole, MD

A draft recommendation by the U.S. Preventive Services Task Force calling for an end to routine PSA testing for healthy men age 50 and older goes too far, says a prostate cancer expert at the Alvin J. Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital.

"Routine annual PSA screening is not necessary for most men. But men with a high risk of dying from prostate cancer — particularly African Americans and those with a family history of prostate cancer — should still be screened.”
 — Gerald L. Andriole, MD

“Mass screening is not the way to go,” says Gerald L. Andriole, MD, chief of urologic surgery, who acknowledges that widespread testing has led many men with slow-growing tumors to be overdiagnosed and overtreated. “We have to take a more nuanced approach to determine which men should be screened in the first place, how frequently they should be tested, and whether their cancer warrants therapy.”

Andriole, who also is the principal investigator of the National Cancer Institute’s Prostate, Lung, Colorectal and Ovarian (PLCO) screening trial, argues that it would be a mistake to universally dismiss the PSA test. Rather, he says the decision to screen should be left up to patients and their doctors, who should take into consideration a man’s overall health, age and other risk factors.

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