For Some, Prostate CA Screening Can Be Difference Between Life and Death

May 31, 2012

By Fran Lowry

NEW YORK (Reuters Health) May 29 - Men of lower socioeconomic status and those from third world countries are a subset of patients who do need prostate-specific antigen screening, researchers said last week at the 107th Annual Scientific Meeting of the American Urological Association (AUA) in Atlanta, Georgia.

That's because these men often present with advanced, metastatic prostate cancer, Dr. Brian K. McNeil, from SUNY Downstate Medical Center, Brooklyn, NY, told Reuters Health in an interview.

"Considering the recent controversies regarding PSA screening, including the recent US Preventive Task Force recommendation against screening, we decided to study those patients in our population who presented to Downstate with metastatic prostate cancer to identify those who would suffer if PSA screening was eliminated," Dr. McNeil said.

He and his team searched a prospectively maintained androgen deprivation therapy database from their inner city hospital and identified 148 men who presented with metastatic prostate cancer.

At presentation, the median age was 69, and the median Gleason sum was 8 on prostate biopsy.

Of the men who underwent radiographic imaging, 50 (45%) had lymphadenopathy suspicious for metastasis, 14 (19%) had masses suspicious for visceral metastases and three (4%) had evidence of local progression.

All patients had bone scans. Virtually all (97%) had positive findings, with 11 (7%) showing signs of cord compression.

The median time for rise of PSA levels after they reached a nadir was 228.5 days.

The median survival duration was slightly more than four years. Two- and five-year cancer specific survival rates were 68% and 39%, respectively.

"The scary thing for me is that the US Preventive Service Task Force recommendations could discourage some men from getting screened who would benefit from screening. With the patients in our study, who knows what would have happened if they were screened and the cancer was detected much earlier," Dr. McNeil said.


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