Prostate screening no help in men over 75: U.S. panel

CHICAGO (Reuters) - Prostate cancer screening is not likely to benefit men over age 75 and is not recommended for them while more evidence is needed to determine whether younger men benefit from early detection of the slow-growing disease, a panel of experts said on Monday.

The recommendations from the U.S. Preventive Services Task Force -- a government appointed panel -- address a simmering debate on the risks and benefits of screening with a prostate-specific antigen, or PSA, blood test for prostate cancer.

In most cancers early detection is paramount but in prostate cancer, which often grows very slowly and may not kill an older man before he dies of something else, the risks of early treatment may not outweigh the benefits.

In recommendations published in the Annals of Internal Medicine, the panel said there is not enough evidence to show that early treatment based on detection from PSA testing can improve a man's chances of survival.

"We carefully reviewed the available evidence to measure the benefits and harms of screening for prostate cancer and could not find adequate proof that early detection leads to fewer men dying of the disease," said Dr. Ned Calonge of the Colorado Department of Public Health and Environment, who was chairman of the task force.

"At this point, we recommend that men concerned about prostate cancer talk with their health-care providers to make a decision based on their individual risk factors and personal preference," Calonge said.

The recommendations follow several studies that have suggested frequent prostate cancer screening does little to reduce the risk of death from the disease but significantly adds to the cost and worry over this cancer, which is found in 780,000 men every year globally and kills 250,000.

The panel reviewed studies since its last recommendations in 2002. It concluded that for men under age 75, there is too little evidence to determine whether treatment for prostate cancer detected by a PSA blood test offers any benefit over treatment given after cancers are detected by other means, usually when symptoms begin.

For men over 75, the panel said "the incremental benefits of treatment for prostate cancer detected by screening are small to none."

Prostate cancer does not always require immediate treatment. Early treatment carries a number of potential drawbacks, including erectile dysfunction, urinary incontinence, bowel dysfunction and the risk of death.

"Men should be informed of the gaps in the evidence and should be assisted in considering their personal preferences before deciding whether to be tested," the panel said.

The group said two large studies under way -- one in the United States and one in Europe -- should help clarify questions about the benefits of screening in men under 75.