Researchers say initial PSA test should occur at age 44 to 50; if levels low, annual test unneeded
Thursday, May 19, 2011 (Last Updated: 05/23/2011)
THURSDAY, May 19 (HealthDay News) -- Men with low prostate-specific antigen (PSA) levels upon initial testing at age 44 to 50 years are at lower risk for aggressive prostate cancer and do not need to undergo annual testing, according to research to be presented at the annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.
As part of the Malmö Preventive Project in Sweden, Hans Lilja, M.D., Ph.D., of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues evaluated archived blood samples from 12,090 men aged 44 to 50 years who provided blood between 1974 and 1986, and repeat samples from 4,999 of those men six years later. The investigators also analyzed blood samples from an independent cohort of 1,167 men aged 60 years. All of the men included in the analysis had not undergone any screening for prostate cancer.
The data revealed that a PSA level below the median among men aged 44 to 50 years was associated with a very low risk of prostate cancer death or metastases within 15 years, but not necessarily lifetime risk. In addition, the risk decreased significantly, down to 0.5 percent, for 60-year-olds with a PSA level below the median. The investigators suggest that men should receive an initial PSA screening at age 44 to 50 and that those at low risk at this screening should not undergo annual PSA testing but instead have a second test between ages 51 and 55. If their PSA levels are still low, they should receive a final test at age 60, according to the investigators.
"This research helps us distinguish between those men who may benefit from regular PSA screening for prostate cancer and those men who may not need to be screened so frequently," Lilja said in a statement. "Instead of testing all men each year or every two years, screening and surveillance efforts can be focused on early detection of prostate cancer in those men who are found to be at high risk of death from the disease."
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