Do PSA Tests Give Accurate Diagnoses?

By Tom McIntyre

July 15, 2010 Updated Apr 14, 2009 at 6:26 PM CDT

One in six men are diagnosed with prostate cancer. But there's an even big question today on whether healthy men should get PSA tests to screen for it.

The test does save lives. New studies say for every life saved, dozens more men may be misdiagnosed or exposed to harmful side effects.

Mitch Laurance is a six year prostate cancer survivor, and despite concerns about the psa test, he thinks every man should at least consider it.

"Men are hesitant to go ahead and get tested now. The last thing that I wanna see is that they hear this and say 'Oh, see I'm not gonna have a PSA test," said Laurance.

Most major medical groups don't recommend routine psa tests in healthy men.

The national cancer institute found men who got the psa or a digital rectal exam lived no longer than those who didn't.

In Europe, screening reduced deaths by 20 percent. But for every life saved, 47 patients suffered needless biopsies and side effects
Prostate cancer can be deadly. But not all types are harmful.

Many men live and die with slow–growing cancers that don't need treatment. But screening tests can't tell the difference.

"That may happen in England, but I don't see that in Central Illinois. Like I said, our biopsy infection rate is one and a half percent and that's much lower than European literature," said Dr. Joe Banno with Midwest Urological.," said Dr. Banno.

Researchers are working on it. More specific blood tests and pin–point imaging for men, like mammograms detect breast cancer in women.

"I think the next step is tom develop different molecular models—which show which cancer will be aggressive and which one isn't. We're not there yet".

"We are very close. We are no more than five years away. But what we need to give that is significant government investment," said Dr. Faina Shtern with Admetech Foundation.

They're hoping for 500 million of the stimulus money set aside for research.

In the meantime, the decision about whether to test psa is left up to
patients and their doctors.

There are some men, with family histories or urological problems, who doctors say should get the test even with the risk of over diagnosis.

"African–Americans over the age of 40 should get screened on a regular basis. If the incidence is one in nine in Caucasians, it's two in nine in African Americans. Patients which a family history should be screened after the age of 40," said Dr. Banno.