Study Supports Halt of PSA Testing in Some Older Men

Those 75 to 80 with prostate specific antigen less than 3 ng/mL unlikely to develop high-risk prostate cancer

02 mar 2009-- Men who are 75 to 80 years old and have a prostate specific antigen (PSA) less than 3 ng/mL are not likely to have life-threatening prostate cancer during the remainder of their lives, according to research released online in advance of publication in the April issue of the Journal of Urology.

Edward M. Schaeffer, M.D., Ph.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data from 122 men with prostate cancer and 727 without the disease in the Baltimore Longitudinal Study of Aging cohort. The primary outcome was death from prostate cancer or development of aggressive prostate cancer.

None of the men between the ages of 75 and 80 who had PSA less than 3 ng/mL died of prostate cancer, the researchers report. However, men of all ages who had PSA of 3 ng/mL or greater had a continually increasing chance of death from the disease, the investigators found.

"The optimal approach to prostate cancer screening remains controversial. To date there is limited evidence with which to inform the decision of when to discontinue prostate cancer screening," the authors write. "Our findings suggest that men 75 to 80 years old who have a PSA less than 3 ng/mL are unlikely to be diagnosed with high-risk prostate cancer during life. Therefore, these men may represent an ideal target group for discontinuation of PSA testing, which could dramatically reduce the costs associated with screening, as well as the potential morbidity of additional evaluations and/or treatment in a population unlikely to experience benefit."

Schaeffer disclosed a relationship with Covidien.

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