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Government Panel Thumbs Down PSA Test

The government-sanctioned United States Preventive Services Task Force has reported that the P.S.A. blood test to screen for prostate cancer does not save lives and leads to more tests and treatments that cause pain, impotence and incontinence, according to a story in today's (Oct. 7) New York Times.

There are 44 million men over 50 in the U.S. and 33 million have had P.S.A. tests, sometimes without their knowledge, says the task force. The former San Diego biotech Hybritech developed a commercial version of the P.S.A. test in the 1980s. The company was sold for $400 million; Hybritech insiders went on to launch other biotech firms, often as venture capitalists.

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The government-sanctioned United States Preventive Services Task Force has reported that the P.S.A. blood test to screen for prostate cancer does not save lives and leads to more tests and treatments that cause pain, impotence and incontinence, according to a story in today's (Oct. 7) New York Times.

There are 44 million men over 50 in the U.S. and 33 million have had P.S.A. tests, sometimes without their knowledge, says the task force. The former San Diego biotech Hybritech developed a commercial version of the P.S.A. test in the 1980s. The company was sold for $400 million; Hybritech insiders went on to launch other biotech firms, often as venture capitalists.

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Comments
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These comments seem to indicate that PSA tests result in unnecessary therapy or intervention. The real downside of that test, in my research, is that it gives both false positives and false negatives. I lost a good friend to prostate cancer whose diagnosis came too late for any sort of therapy to save his life. Another acquaintance died in his early 50's when his case was far advanced at diagnosis. My father's case had spread to the bone before it was detected, and he suffered with the bone cancer in his later days.

In my own case, while my PSA levels were normal, I requested and received ultrasound testing which indicated a need for biopsies. Those came back positive for a moderately aggressive condition. The PSA often does not detect the presence of prostate cancer until it has spread beyond the prostate. By then it is too late. If the cancer can be detected while still encapsulated within the gland, it can usually be stopped. That was what happened to me, and why all these years later I can still comment on Reader blogs.

If the reason for eliminating the test is to avoid detecting slow-moving cases of prostate cancer that would progress so slowly that they would never prove fatal, that's one thing. But if you eliminate any test that detects a case some of the time, that means that more men will die of undetected cases of prostate cancer. What we need is a better test than the PSA, yet much cheaper, simpler and less invasive than current ultrasound.

Oct. 8, 2011

PSA has been controversial. The New York Times had a story last year, too, on questions about this test. Your analysis looks logical, although I don't know that much about the topic. Best, Don Bauder

Oct. 8, 2011

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