DANVILLE - When it comes to prostate-specific antigen (PSA) testing for prostate cancer, there are two schools of thought: Critics of the screenings contend that the adverse effects of treating screened cancers outweigh the benefits.
Screening advocates counter that lives can be saved by early detection and treatment.
Geisinger oncologists and urologists agree.
PSA screening measures PSA levels in a man's blood and, depending on the levels detected, physicians may recommend either a wait-and-see approach or a prostate biopsy.
"Geisinger prostate cancer specialists are very concerned about the recommendation of the U.S. Preventative Services Task Force against performing PSA testing," said Dr. John Danella, urologist at Geisinger Medical Center. "In the 20 years since PSA testing has become widespread in the US, the prostate cancer specific death rate has decreased by 40 percent.
"It is very probable that early detection through PSA testing accounts for most of this decrease," he added. "Although the PSA test can detect low risk cancers that don't require treatment, the patients with those cancers can be managed by an active surveillance strategy, thereby lessening the burden of treatment-related side effects."
Elevated PSA levels also can be caused by noncancerous conditions, such as benign prostatic hyperplasia (BPH) or infections, said Dr. Omar Yumen, a radiation oncologist at Geisinger.
Nevertheless, the PSA test still "is the best method of detecting prostate cancer while it is still curable. If a man is concerned about potentially dying from or suffering the consequences of prostate cancer, he should be screened," Yumen said.
Both physicians suggest men speak with their doctors to assess their risks for prostate cancer and whether they should be referred to take a PSA.
They recommend that both healthy men with a 10-year life expectancy and African American men with a family history of prostate cancer should get an annual PSA test beginning at age 45.
According to the American Urological Association Foundation, prostate cancer is the most common non-skin cancer and second-leading cause of cancer death in American men.
