Two new studies have found that the number of prostate cancer cases has gone down, along with the number of men who are getting screened for the disease. The question is, is this a good thing or a bad thing?
Going through a prostate-specific antigen (PSA) test had been common practice for men over the age of 50 until 2012, when the U.S. Preventive Services Task Force (USPSTF) recommended against it. USPSTF said that the test subjected men to unnecessary treatments that had long-term effects. From that time on, the number of prostate cancer cases being detected has gone down, and more men are skipping the PSA test.
In the first study, researchers from the American Cancer Society reported that in 2010, 38 percent of men went through the PSA test, but that number went down to 31 percent in 2013. Consequently, the number of men diagnosed with prostate cancer also went down from 213,000 in 2011 to 180,000 in 2012.
"The decline in incidence and the decline in the proportion of men getting screened likely means that doctors and patients are beginning to understand that it's not known whether prostate cancer screening saves lives," Dr. Otis Brawley, American Cancer Society's chief medical officer, told HealthDay. "One of the things we do know is that screening is more likely to diagnose the kind of [prostate] cancer that is not a threat to health and does not need treatment."
In the second study, researchers from Brigham and Women's Hospital, Dana-Farber Cancer Institute and Henry Ford Health System also found that PSA screening went down for men aged 60 to 64, from 45 percent in 2010 to 35 percent in 2013, and for men aged 50 to 54, from 23 percent in 2010 to 18 percent in 2013.
However, unlike the researchers from the American Cancer Society, the authors of the second study believe that there could be patients who need to be screened but are not undergoing PSA test.
"This study raises a troubling suggestion that we may be missing patients we want to find with screening," Dr. Richard Greenberg, chief of urologic oncology at Fox Chase Cancer Center, told HealthDay. "Specifically, younger men who are currently not getting screened may have cancer 10 years from now that is no longer curable."
The researchers from both groups agree that men should talk to their doctor about the PSA test and decide for themselves if they will go through it. Men at increased risk - black men or those whose fathers were diagnosed with prostate cancer before age 65 - should discuss the issue with their doctor when they reach age 45.
The findings follow shortly after Swedish researchers published a study earlier this month about a blood test that can detect if prostate cancer is benign or aggressive, a promising method that can help men avoid unnecessary treatments.
The studies were published in the Nov. 17 issue of JAMA.
