Prostate Screening Tests and Peyronie’s Disease

Older men undergoing unnecessary PSA screening

A new study from the University of Chicago reports on the use of PSA-based prostate cancer screening in the United States, concluding that many elderly men could be receiving excessive and unnecessary prostate cancer screening tests.  This same study also determines that while elderly men are over-tested for prostate cancer, while a significant percent of men in the 50-60 age group are not being tested enough for prostate cancer.

The prostate specific antigen (PSA) test is used to help detect prostate cancer or other prostate abnormalities.

These same University of Chicago researchers report that data from two separate surveys conducted in 2000 and 2005 found that slightly less than half of men in their seventies received PSA screening tests within the prior year, a number almost double the PSA screening rate of men in their early fifties.  Consistent with this trend, men who are 85 years and older were given PSA screening tests about as often as men in the 50-60 age group.

Senior author of this study, Scott Eggener, MD, said, “Our findings show a high rate of elderly and sometimes ill men being inappropriately screened for prostate cancer. We’re concerned these screenings may prompt cancer treatment among elderly men who ultimately have a very low likelihood of benefiting the patient and paradoxically can cause more harm than good. We were also surprised to find that nearly three-quarters of men in their fifties were not screened within the past year.”  In the active study group were 2,623 men age 70 years and older and almost 12,000 men between the ages of 40 and 69 served as the control group. .

Published online in the Journal of Clinical Oncology (March 28, 2011), Dr. Eggener and his colleagues evaluated test  results in 2000 and 2005 of health surveys from randomly selected households, as part of the National Health Interview Survey initiative.  Reviewing this survey data, Dr. Eggener was able to calculate the estimated 5-year life expectancy of each participant over age 40 who had received a PSA test.

The total PSA screening rate for all men (40 years and older) within the past year was 23.7% in 2000 and 26% in 2005. A breakdown of this total number into meaningful groups shows that the PSA screening rate was lowest in the 40 to 44 age group (7.5%), the PSA screening rate increased to 24% in men ages 50 to 54 years.  The PSA screening rate increased again with a peak rate of 45.5% for men  s 70 to 74 years of age. Screening rates then declined with age, with 24.6% of men age 85 years or older reporting being screened.

The study concludes with the suggestion that treating physicians should be more selective in recommending PSA cancer screening tests for elderly male patients who are less likely to receive benefit from the results of that testing.  Instead, they recommend that more rigorous prostate and PSA screening tests should be done routinely for those men who are in the younger and healthier 40-50 age groups, since it is they who will more likely benefit from early prostate cancer diagnosis.

How does this relate to Peyronie’s disease?  Well, it shows that as your medical doctor is recommending tests and procedures for you, he is also calculating values and factors that might  not be related to your direct benefit.  This is the aspect of modern government-managed and insurance company-dictated health care that is warned about.   Medical decisions are made for you and about you that are based on what is good for others.  Keep this in mind when health care options are being given to you.

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