Certain men ages 75 to 80 are unlikely to benefit from
routine prostate specific antigen testing, according to a
Johns Hopkins study published in the April issue of The
Journal of Urology.
The researchers found that men in this age group with PSA
levels less than 3 nanograms per milliliter are unlikely to
die of or experience aggressive prostate cancer during
their remaining life, suggesting that the use of PSA
testing in many older men may no longer be needed.
The study, led by researchers from the Johns Hopkins
University School of Medicine and the National Institute on
Aging's Baltimore Longitudinal Study of Aging, reviewed
data from 849 men (122 with and 727 without prostate
cancer) who were participating in the Baltimore
Longitudinal Study of Aging and who had undergone regular
Results showed that among men who were over 75 with PSA
levels less than 3 nanograms per milliliter, none died of
prostate cancer and only one developed high-risk prostate
cancer. In contrast, men of all ages with a PSA level of 3
nanograms per milliliter or greater had a continually
rising probability of dying from prostate cancer.
If confirmed by future studies, these results may help
determine more specific guidelines for when PSA-based
screening might be safely discontinued, according to lead
investigator Edward Schaeffer, an assistant professor of
urology at Johns
Hopkins. While PSA screening remains a useful tool for
helping detect early stages of prostate cancer and is
credited with decreasing prostate cancer mortality,
discontinuing unneeded PSA testing could significantly
reduce the costs of screening and also potentially reduce
morbidity resulting from additional tests or treatments.
"We need to identify where we should best focus our health
care dollars by concentrating on patients who can actually
benefit from PSA testing," Schaeffer said. "These findings
give a very strong suggestion of when we can start to
counsel patients on when to stop testing."
Other Johns Hopkins researchers who participated in this
study are H. Ballentine Carter, Anna Kettermann, Stacy
Loeb, Luigi Ferrucci, Patricia Landis, Bruce J. Trock and
E. Jeffrey Metter.