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Other study finds that before 2008 guidelines, health and life expectancy affected PSA screening

-- Eric Metcalf

Monday, May 17, 2010 (Last Updated: 05/18/2010)

MONDAY, May 17 (HealthDay News) -- Men with low-risk prostate cancer on active surveillance generally have favorably low anxiety and distress in the first nine months of surveillance, according to research published in the May issue of The Journal of Urology. Another article in the same issue examines how health status and life expectancy influenced selection of men age 75 and older for prostate-specific antigen (PSA) screenings before the United States Preventive Services Task Force (USPSTF) recommended against screening them.

Roderick C.N. van den Bergh, M.D., of the Erasmus Medical Center in Rotterdam, Netherlands, and colleagues analyzed data from men with prostate cancer on active surveillance who answered questionnaires shortly after their diagnosis and again at nine months. Only two of 129 discontinued active surveillance for non-medical reasons. The researchers found that anxiety and distress at nine months were largely predicted by scores at inclusion, and that men with a less neurotic personality and good physical health tend to do best psychologically during surveillance.

Karen E. Hoffman, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues write that the USPSTF 2008 guidelines recommend against PSA screening in men age 75 or older. In their analysis of 718 men of this age group included in a 2005 survey, they found that those in fair or poor health were less likely to have PSA screening in the previous two years than those with very good or excellent health (adjusted odds ratio, 0.51). Men predicted to live less than five years were less likely to have had recent PSA screening than those predicted to live more than 10 years (42 versus 65 percent).

"A strict screening age cutoff of 75 years reduces over screening and over diagnosis in some men with a short life expectancy but also prohibits PSA screening in healthy older men with a long life expectancy who may benefit from the early detection of aggressive prostate cancer. The results of this study highlight the need for future study of the impact on prostate cancer mortality when using a strict age cutoff for screening in healthy older men," Hoffman and colleagues write.

Abstract- van den Bergh
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Abstract - Hoffman
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Specialties Urology
Hematology & Oncology
Psychiatry
Pathology
Geriatrics
Family Practice
Internal Medicine

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