A Study that is pro-PSA Testing

The article full text is available here:

jnci.oxfordjournals.org/content/early/2014/03/07/jnci.dju007.full.pdf+html

The fact that the higher use of PSA testing has been associated with lower PCa mortality is not new but it has been ignored by those that continue to support the notion that there is limited value in testing with PSA for prostate cancer. Those folks have never fully explained the PCa mortality reduction experienced in the USA as compared to other countries in which the use of PSA is low or not available. In many of those countries there has not been a decline in mortality and in some countries there has been mortality increases.

Those treating PCa here need to avoid treating many men who could avoid the harms of treatment without the risk of cancer affecting them. This is something to consider here where the guidelines for testing with PSA, if followed as recommended, will result in an increase of deaths…

The authors concluded:
“In conclusion, in our population-based study we observed lower
incidence of metastatic prostate cancer, lower prostate cancer–specific mortality, and lower excess mortality in counties with high
vs low incidence of prostate cancer, reflecting PSA uptake. This
indicates that more-intense as compared with less-intense opportunistic PSA screening reduces prostate cancer mortality.”

Test, but be responsible by avoiding unnecessary treatment when possible!

RalphV

Thank you Tud and RalphV for bringing this to our attention; and the beat goes on! On our national level, as part of the the Federal Government the CDC(Center for Disease Control) follows the recommendations of the USPSTF and does not publish it's own prostate cancer screening guidelines.
In contrast, the "VHA National Center for Health Promotion and Disease Prevention" has published their own guidelines which are not in the public domain. Unlike USPSTF, the VHA statement does "not recommend for or against" screening men who may be at increased risk of prostate cancer. The reason for varying from the USPSTF is that the VHA serves a different population than that included in the PLCO and ERSPC trials. The VHA has a greater proportion of African American men and also serves veterans of the Vietnam War era who may have been exposed to Agent Orange.

In any case, the "Clinical Preventive Service Guidance Statement: Prostate Cancer Screening" requires that the patient specifically request a psa test. This guidance is being ignored by many VA physicans and psa tests are being performed.
Bill