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More Research Finds Limited Benefit From PSA Test

Also, many men not fully sharing in decision with provider whether to undergo testing

WEDNESDAY, Sept. 30 (HealthDay News) -- Men should be aware of their chances of benefits and harms from prostate-specific antigen (PSA) testing before the test, but many are not discussing screening before making the decision, according to the results of two studies in the Sept. 28 Archives of Internal Medicine.

Kirsten Howard, Ph.D., of the University of Sydney in Australia, and colleagues analyzed data from a model comparing outcomes from prostate cancer in men with and without annual screening. The authors presumed a 20-percent relative risk reduction in prostate cancer mortality in screened men as a best case. If 1,000 men were screened from ages 40 to 69, they would have 27.9 prostate cancer deaths and 639.5 deaths overall by age 85, compared with 29.9 prostate cancer deaths and 640.4 deaths overall in their unscreened counterparts. False alarms were a concern, along with the attendant risks of biopsies triggered by the screening.

Richard M. Hoffman, M.D., of the New Mexico VA Health Care System in Albuquerque, and colleagues analyzed data from 375 men, ages 40 and older, who had undergone or discussed PSA testing with their health care provider in the previous two years. Only 69.9 percent discussed screening before making a decision. The provider was more likely to raise the idea and was more likely to emphasize benefits of testing than shortcomings (71.4 versus 32 percent).

"Even if there is a small expected benefit from screening under optimistic assumptions, it is unlikely that screening represents a good value for the expenditure of resources based on the potential cost per quality-adjusted life-year gained," writes the author of an accompanying editorial.

Several authors of the second study reported financial associations with the Foundation for Informed Medical Decision Making, which supported the study.

Abstract - Howard
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Abstract - Hoffman
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