A panel of experts recommended to routinely screen blood for prostate cancer, in a report published on Wednesday in The BMJ.
The panel, consisting of general practitioners, urologists, methodologists and patients, listed five clinical trials that assessed the use of a blood test for prostate specific antigen (PSA) in screening for prostate cancer. The use of this screening test did not lead to a significant decrease in the total death of the patient according to the study.
Prostate cancer screening is a controversial topic in the field of medicine. PSA screening has definitely led to an increase in the detection of prostate cancer. "The problem is that the PSA test, the only test currently available, has a high incidence of false-positive and false-negative results, and many cancers detected via PSA are indolent and would never hurt the patient do, "said Dr. Martin Roland, emeritus professor of Health Services Research at the University of Cambridge, said in an editorial comment. Current tests can not reliably identify aggressive behavioral cancers, and those are the ones that can kill.
New methods for the management of prostate cancer, including prostate MRI and MRI-guided biopsies, despite the promising results are not available everywhere for the general population.
False positive PSA results cause unnecessary treatments and treatment side effects can be significant. Not only can biopsies and surgeries cause infection, but they can also lead to urinary incontinence and erectile dysfunction. After surgery, incontinence was seen in up to 17 percent of patients and erectile dysfunction was observed at up to 83 percent.
The recommendations come after the recent changes to the recommendations of the United States Task Force Preventive Services in May 2018. They now encourage PSA screening to take an individual decision. No recommendations for general population surveys. However, the panel warned that certain groups, such as those with a family history of prostate cancer, might want to consider PSA screening.
Dr. Jonathan Steinman is a radiology doctor and writer at the ABC News Medical Unit.