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Prostate-Specific Antigen Test Overused in Elderly Men

More than half are being tested despite guidelines, study finds

TUESDAY, Nov. 14 (HealthDay News) -- Despite guidelines suggesting the test does elderly patients more harm than good, U.S. physicians routinely perform prostate-specific antigen (PSA) screenings on males over 70, according to a report in the Nov. 15 Journal of the American Medical Association. The findings were presented Nov. 14 at a special American Medical Association men's health news briefing in New York City.

In the study, Louise C. Walter, M.D., and colleagues at the University of California San Francisco examined 2003 U.S. Department of Veterans Affairs data on nearly 600,000 male veterans, aged 70 or over, who were treated at 104 VA facilities nationwide.

Fifty-six percent of these elderly patients received a PSA test in 2003. Although the rate of testing did decline with advancing patient age, the percentage of men receiving the test did not fall with worsening health -- 34 percent of men aged 85 and older rated in "best health" were screened versus 36 percent deemed to be in worst health.

The researchers conclude that rates of PSA screening among the elderly "should be much lower than current practice given the known harms of screening."

In his editorial, Peter C. Albertsen, M.D., of the University of Connecticut Health Center in Farmington, adds that many elderly men have an exaggerated fear of the danger from prostate cancer and the effectiveness of treatment for their age group. According to Albertsen, physicians must counsel these patients that, "When the [PSA] test is applied to older men, the benefits are not likely to exceed the potential harms."

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Physician's Briefing