Study: Prostate-specific antigen screening may be discontinued in some older men

The discontinuation of routine PSA screening in certain elderly men may not increase the rates of undetected lethal disease and could avoid potentially unnecessary treatments and reduce diagnostic costs, according to a new study.

The study, conducted by investigators from the Baltimore Longitudinal Study of Aging and the Johns Hopkins School of Medicine, Baltimore, involved 849 men (122 with and 727 without prostate cancer) with serial PSA measurements. For men over age 75 years with PSA Journal of Urology.

“The optimal approach to prostate cancer screening remains controversial,” wrote lead author Edward M. Schaeffer, MD, PhD, of the Brady Urological Institute at Johns Hopkins. “To date, there is limited evidence from which to inform the decision on when to discontinue prostate cancer screening.

“Our findings suggest that men at an age of 75 to 80 years who have a PSA level below 3.0 ng/mL are unlikely to be diagnosed with a high-risk prostate cancer during life. These men may therefore represent an ideal target group for discontinuation of PSA testing, which could dramatically reduce the costs associated with screening and the potential morbidity of additional evaluations and/or treatment in a population unlikely to gain benefit.”

Dr. Schaeffer emphasized that these findings need to be confirmed in a much larger study, and that men over 75 years of age should continue to be monitored for development of clinical signs of prostate cancer.