Most Older Men Say They
Want Prostate Cancer Test Despite Risks, Task Force Objections
Although experts say middle-aged men should not have
routine PSA tests, majority of older men disagree, especially those of
higher income, black or had recent test
By Valerie DeBenedette, HBNS Contributing Writer
July 11, 2013 - A survey of men age 40 to 74 found
that 54 percent say that they would still opt for a popular prostate
cancer screening test despite recent recommendations that the test not
be performed, finds a new study in American Journal of
Preventive Medicine. Only 13 percent said they would choose
not to be tested.
The U.S. Preventive Services Task Force (USPTF)
recommends that middle-aged men not receive the prostate-specific
antigen test (PSA) because research has shown that the benefits of
testing do not outweigh the risks, which include false positive results.
More than three quarters of the men who
participated in the survey said they were not aware of the new
recommendation, said Linda Squiers, Ph.D., senior health communication
scientist at RTI International in Rockville, MD, and lead author of the
study. Most men understood the reasoning behind the new recommendation
when it was explained, she noted.
Black men, men with higher incomes, and those who
had had a PSA test in the previous 2 years were more likely to say they
will not follow the new recommendation, according to the new study. Men
who were somewhat or very worried about getting prostate cancer were
also more likely to want testing. The 1,089 men who participated had no
history of prostate cancer.
That so few men said they would follow the new
recommendation is not surprising. Routine testing for many types of
cancer has been promoted for a long time, Squiers also noted. Our
culture is very pro screening. The idea that screening is beneficial and
essential has been drilled into all of us.
David F. Penson, M.D., health policy chair for the
American Urological Association (AUA) and professor at Vanderbilt
University Medical Center in Nashville, agreed. The men in the study
may be saying that while, in general, they may agree with the USPSTF
recommendation for large populations, when they consider their
individual situation and their personal preferences, they would rather
be tested and know their status.
Seventy percent of the men surveyed said that they
either had not discussed the potential benefits or harm of screening
with their health care provider or do not remember such a discussion,
Squiers added. Those who did remember such a discussion only remember
hearing of the benefits of testing. We need to do a better job of
presenting both the benefits and harms of screening to all patients and
explaining the science behind the recommendation in plain language so
everyone can understand it, she said.
The AUA has just released new clinical practice
guidelines on prostate cancer screening. The AUA says that it cannot
recommend for or against routine PSA screening for men age 40 to 54 who
are at average risk for prostate cancer, but does recommend discussions
about testing between physician and patient for men age 55 to 69.
AUA advises that men age 40 and over who are at
increased risk for prostate cancer, including black men and those with a
strong family history, should discuss screening with their provider and
then make an individualized decision about it. The AUA is making a
concerted effort to make the public aware of our new recommendations,
Health Behavior News Service, part of the Center for Advancing Health,
http://www.cfah.org. Research Source: American
Journal of Preventive Medicine
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