At the age of 75, men should stop getting screened for prostate cancer, according to new recommendations from a government task force. The group reported finding evidence that the benefits of treatment based on routine screening of this age group “are small to none” [AP]. Those potential benefits are far outweighed by the possible anxiety, unnecessary surgery, and harmful side effects that elderly men can experience if the screening finds early-stage prostate cancer and the patient chooses to treat it.
Most oncologists already argue against treating most men in that age group for prostate cancer because they are more likely to die from some other cause than from their tumor [Los Angeles Times]. Prostate cancer often progresses slowly, and doctors say it can take 10 years before a patient begins to show symptoms. Many doctors now advocate a “watchful waiting” approach when prostate cancer is detected, instead of aggressive treatment that can cause impotence, incontinence, and bowel problems.
The new guidelines, published in the Annals of Internal Medicine, may change a doctor’s office ritual for elderly men. Prostate screening involves a simple blood test to check for prostate-specific antigen, or PSA. Many doctors find it easier just to do a PSA test than take the time to explain the pros and cons to a patient. Patients themselves, many accustomed since their late 40s or early 50s to getting tested, aren’t always comfortable with the idea of stopping the screening once they reach older age [The New York Times blog].
But some doctors take issue with the recommendations and argue that with medical technology improving all the time, 75-year-olds can have many productive years ahead of them and should be more protective of their health. “I think they’re really missing the boat,” said William J. Catalona, a professor of urology at Northwestern University. “It’s a disservice to patients. A lot of men die from prostate cancer, and there’s just an overwhelming amount of evidence that screening saves lives” [The Washington Post].