No Survival Bump With More Frequent PSA Screens for Localized Prostate Cancer

Excerpt:

“Undergoing more frequent prostate-specific antigen (PSA) screening after radical prostatectomy or primary radiation for localized prostate cancer was not associated with improved overall survival (OS), regardless of disease risk, according to results of the AFT-30 study (abstract 6503) presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 1–5 in Chicago.

“‘Based on our study results, PSA testing every 3 to 6 months may represent overutilization of care,’ said Ronald Chen, MD, of the University of North Carolina at Chapel Hill. ‘This study provides empiric data to inform future guidelines and clinical practice.'”

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One-Off PSA Screening for Prostate Cancer Does Not Save Lives

Excerpt:

“Inviting men with no symptoms to a one-off PSA test for prostate cancer does not save lives according to results from the largest ever prostate cancer trial conducted over 10 years by Cancer Research UK-funded scientists and published today (Tuesday) in the Journal of the American Medical Association (JAMA).

“Researchers at the Universities of Bristol and Oxford found that testing asymptomatic men with PSA detects some disease that would be unlikely to cause any harm but also misses some aggressive and lethal prostate cancers.”

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A New Study Claims Prostate Cancer Screenings Significantly Reduce Deaths. Not Everyone Agrees

Excerpt:

“An analysis of two influential studies of prostate cancer screening concludes that the much-debated test “significantly” reduces deaths from the disease, suggesting that current recommendations against routine PSA screening might be steering men away from a lifesaving procedure.

“The analysis, published Monday in Annals of Internal Medicine, drew wildly different reactions, as is often the case with research on PSA screenings. Some experts in cancer screening and statistics said its novel approach was “on shaky ground” and used a “completely unverifiable” methodology that they had “never seen before,” but others praised its “intriguing and innovative approach.” There was one area of agreement, however: “I imagine it’s going to generate some buzz,” said biostatistician Ted Karrison of the University of Chicago.”

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New Prostate Cancer Tests Aim to Reduce the Death Rate

Excerpt:

“About a dozen new medical tests are coming to market that aim to more accurately diagnose prostate cancer and go well beyond the standard PSA (prostate-specific antigen) blood screenings used today. Several of them may even allow men to forego getting a biopsy that more than 1 million men diagnosed with prostate cancer undergo each year. That’s because these new tests will help doctors distinguish between aggressive disease and slow-growing tumors.”

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Treat or Monitor Early Prostate Cancer? 10-Yr Survival Same

Excerpt:

“Men with early prostate cancer who choose to closely monitor their disease are just as likely to survive at least 10 years as those who have surgery or radiation, finds a major study that directly tested and compared these options.

“Survival from prostate cancer was so high—99 percent, regardless of which approach had—that the results call into question not only what treatment is best but also whether any treatment at all is needed for early-stage cases. And that in turn adds to concern about screening with PSA blood tests, because screening is worthwhile only if finding cancer earlier saves lives.”

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Increasing the Odds of Prostate Cancer Detection

Excerpt:

“For three years, Andrew Harder wondered if he had prostate cancer. In 2009, he had routine blood work that revealed an elevated prostate-specific antigen (PSA) level. When PSA is above 4 nanograms per milliliter of blood, it can be one of the first signs of a prostate tumor. Harder’s PSA was 9.

“By the time Harder saw a urologist, it had skyrocketed to 20. His doctor recommended the traditional next step: a transrectal ultrasound (TRUS) biopsy, which involves taking random tissue samples from 12 cross sections of the prostate.

“Over the course of two years, Harder, 60, an MRI technologist, would have three TRUS biopsies. They were all inconclusive.”

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Flawed Study of Advanced Prostate Cancer Spreads False Alarm

Excerpt:

“Bad news for men popped up in news media all over the country this week, based on a study from Northwestern University reporting that cases of advanced, aggressive prostate cancer had risen sharply from 2004 to 2013.

“Newsweek, NBC, CBS, Fox News and United Press International were among the organizations that covered the study. The reports suggested that recent medical advice against routine screening might be to blame for the apparent increase in advanced cases, by leading to delays in diagnosis until the cancer reached a late stage. Another factor cited was the possibility that prostate cancer had somehow become more aggressive.

“But the frightening news appears to be a false alarm — the product of a study questioned by other researchers but promoted with an incendiary news release and initially reported by some news media with little or no analysis from outside experts.”

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NewYork-Presbyterian and Weill Cornell Medicine Urologists Urge Reconsideration of Prostate Cancer Screening After Finding Critical Flaw in Landmark Study

Excerpt:

“Evidence now favors that prostate specific antigen (PSA) testing can help reduce the number of fatal cases of prostate cancer, contrary to earlier recommendations based on a landmark national study. Researchers from NewYork-Presbyterian and Weill Cornell Medicine discuss their findings related to PSA screening in this week’s New England Journal of Medicine.

“In their letter to the editor, published May 5, the investigators question the results of a large-scale clinical trial assessing the value of PSA screening — which served as the basis for the U.S. Preventative Services Task Force’s 2012 recommendations against routine prostate cancer screening. They say limitations in the study’s methodology underscore the need for healthcare policy leaders to reevaluate the nation’s approach to PSA screening.

“Prostate cancer remains the second leading cause of cancer death among American men and is the most common cancer in men other than skin cancer.”

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PSA Screening Leads to Overtreatment of Low-risk Prostate Cancer Says Long-Term Study

“A paper published in the Journal of Clinical Oncology, authored by Tosoian et al, reports on the long-term outcomes of prospective active surveillance (AS) of patients with favorable-risk prostate cancer.

“The authors point out that the common widespread practice of screening for prostate cancer in the United States, using prostate-specific antigen (PSA), may have led to overdiagnosis and overtreatment of the disease.

“The US Preventive Services Task Force has issued a grade D recommendation to reduce the use of PSA screening, and the National Institutes of Health has made a study of the outcomes of AS a research priority as well.”