PSA is the most commonly used tumor marker for males; at times being asked even at 30 yr just because the person is a very senior executive! There have been guidelines for the same which proclaimed NO testing below 50, unless there is strong family history or the patient wants to.

Team@CMHF

Prostate cancer screening with prostate-specific antigen (PSA) afforded no obvious prostate cancer mortality benefit during 13 years of follow-up in a large randomized trial.

In fact, screened patients had a slightly higher prostate cancer mortality: 3.7 per 10,000 person-years, versus 3.4 for unscreened men.

The results emphasize the need to find some means to identify patients who are most likely to benefit from PSA screening,

“Routine mass screening of the population, purely on the basis of a man’s age, is not going to be an effective way of reducing his chance of dying of prostate cancer,” said Gerald Andriole, MD, of Washington University in St. Louis,

Having said that, that’s not to say that no man should get PSA testing,” he continued. “There are subsets of men in the population at large who do seem to stand a good chance of benefiting from PSA testing.

“Those are men who are young, with no comorbidities, and generally very healthy. These are men with the longest life expectancy overall. They are men who, even if they harbor a nonaggressive, slow-growing cancer, are nonetheless expected to live long enough to die of prostate cancer in the absence of it being identified and treated.”

Screening also is reasonable for men who have an above-average risk of prostate cancer, such as African Americans and men with a strong family history of the disease,.

The data offered nothing to change the conclusions of an earlier analysis of data from the same study, the National Institutes of Health-sponsored Prostate, Lung, Colorectal, and Ovarian (PLCO) screening program. After a median follow-up of seven years (up to as long as 10 years) the screened and unscreened groups had a similar prostate cancer mortality.

The current report showed that after a median follow-up of 13 years, cancer incidence was 108.4 and 97.1 per 10,000 in the screened and unscreened groups, respectively. The difference represented a statistically significant 12% increase in cancer incidence in the screened group

Mortality was 3.7 and 3.4 per 10,000 with and without screening, respectively, a nonsignificant difference.

Responding to the study, Otis W. Brawley, MD, chief medical officer of the American Cancer Society, acknowledged that the results are consistent with other studies that have pointed to a potential harm from overscreening and unnecessary treatment of indolent prostate cancer.

“This trial does suggest that if there is truly an advantage to mass [PSA] screening it is small,”

Even so, the results do not rule out the possibility of a benefit in some high-risk men or the value of PSA screening in men who want the test, he added.

“I truly believe that a man who is concerned about prostate cancer and understands that experts are not certain that screening saves lives, but it definitely causes anxiety and needless treatment, can reasonably choose to be screened,” said Brawley.

“A man who is more concerned with unnecessary diagnosis and treatment might reasonably choose not to be screened. It is an area that needs to be left to an informed patient.”

Ref: http://www.medpagetoday.com/HematologyOncology/ProstateCancer/30548?utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&email=drsumanrao21@gmail.com&eun=g371326d0r&userid=371326&mu_id=