WASHINGTON — The blood test millions of men undergo each year to screen for prostate cancer leads to so much unnecessary anxiety, surgery and complications that doctors should stop testing elderly men, and it remains unclear whether the test is worthwhile for younger men, a federal task force concluded Monday.
In the first update of its recommendations for prostate cancer screening in five years, the widely respected panel that sets government policy on preventive medicine said that the evidence that the test reduces the cancer’s death toll is too uncertain to endorse routine use for men at any age, and the potential harms clearly outweigh any benefits for men age 75 and older.
“The benefit of screening at this time is uncertain, and if there is a benefit, it’s likely to be small,” said Ned Calonge, who chairs the 16-member U.S. Preventive Services Task Force.
“And on the other side the risks are large and dramatic,” he added.
The task force and other groups had concluded previously that it was unclear whether the benefits of the prostate- specific antigen, or PSA, test outweigh the risks. The new review of the scientific literature found no evidence to alter that assessment for younger men but that enough new data had emerged to recommend for the first time against screening for older men.
“We felt with sufficient certainty that your risk of being harmed exceeded your potential benefits starting at age 75,” Calonge said.
The guidelines — which address perhaps the most important and contentious issue in men’s health — were praised by officials at several leading medical groups, including the National Cancer Institute and the American Cancer Society. But they drew strong criticism from others who are convinced routine screening is necessary.
“I think they’re really missing the boat,” said William Catalona, a professor of urology at Northwestern University. “It’s a disservice to patients. A lot of men die from prostate cancer, and there’s just an overwhelming amount of evidence that screening saves lives.”
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