New Guidelines Rule Out Prostate Screening for Men Over 75

The hazards outweigh benefits, government task force reports

By Ed Edelson
HealthDay Reporter

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MONDAY, Aug. 4 (HealthDay News) -- Updated government guidelines take a dim view of prostate cancer screenings at any age and flatly recommend against them entirely for men over 75.

The over-75 rule "is much more explicit than any recommendation out there right now" for using the prostate-screening antigen (PSA) test, said Dr. Michael L. LeFevre, a member of the U.S. Preventive Services Task Force that is updating its 2002 report.

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The new recommendations are published in the Aug. 5 issue of Annals of Internal Medicine.

"The time frame is that the benefit, if there is any, from screening, is 10 years," LeFevre, a professor of family and community medicine at the University of Missouri,, added. "The average life expectancy for men over 75 years is less than 10 years, so screening them can do more harm than good."

For the same reason, men under 75 with serious health problems whose life expectancy is less than 10 years should not get, the task force report said.

Even for younger men with no health problems, "there is uncertainty about whether the benefits exceed the harm, based on existing evidence," LeFevre said.

Prostate cancer is the most common non-skin cancer in the United States, affecting one of every 6 men. Common screening tests are the PSA, which tests for protein blood levels, and a digital rectal examination, which can detect abnormal growth of the gland itself. But neither test can distinguish between prostate cancers that will become life-threatening and those that will grow so slowly that most men die with their prostate cancers, not from them.

"Most of the harms are related to treatment rather than screening," LeFevre said. Surgery and other prostate cancer treatment can cause impotence and damage urinary function and bowel function, he added.

"Men under the age of 75 should try to make an informed choice at this time," LeFevre said of screening tests. "The current evidence is not enough for us to know the balance between benefit and harm."

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