SAN ANTONIO (July 20, 2012) – Debate continues to swirl in the medical community over when to recommend PSA testing to look for prostate cancer in men, and Ian M. Thompson Jr., M.D., director of the Cancer Therapy & Research Center at the UT Health Science Center, is weighing in twice this week in major medical journals.
Dr. Thompson is co-author on an editorial regarding PSA testing recommendations published online Wednesday in the New England Journal of Medicine. The American Society of Clinical Oncology’s PSA panel, on which Dr. Thompson serves, published its opinion Monday in the online edition of the Journal of Clinical Oncology.
The commentaries are in response to the recent recommendations by the U.S. Preventive Services Task Force that doctors stop doing routine PSA tests on men of any age. The task force members looked at data from three studies suggesting that a focus on PSA screening and treatment in recent years has had marginal benefits at great cost.
In the New England Journal editorial, Dr. Thompson and Catherine M. Tangen, Dr.P.H., of the Fred Hutchinson Cancer Research Center, take issue with that recommendation. They note a 44% reduction in prostate-cancer mortality between 1993 and 2009.
“How can this be, if screening and treatment do not reduce deaths from prostate cancer?” the authors ask. The editorial goes on to discuss flaws in the studies that the task force used to arrive at its conclusion.
The ASCO PSA panel opinion discourages PSA testing for men with a life expectancy of 10 years or less, but recommends that men with a greater life expectancy should discuss with their doctors whether PSA screening is appropriate.
“PSA testing may save lives for this group of men, but is also associated with harms, including complications from unnecessary biopsy, surgery, or radiation treatment for cancers that may be slow-growing and not ultimately life-threatening,” the published opinion notes.
“Ultimately,” Dr. Thompson said, “the best people to make the decision about PSA screening are the patient and his doctor, after a thorough discussion about the risks and benefits as they pertain to that individual.”
The Cancer Therapy & Research Center (CTRC) at The University of Texas Health Science Center at San Antonio is one of the elite academic cancer centers in the country to be named a National Cancer Institute (NCI) Designated Cancer Center, and is one of only four in Texas. A leader in developing new drugs to treat cancer, the CTRC Institute for Drug Development (IDD) conducts one of the largest oncology Phase I clinical drug programs in the world, and participates in development of cancer drugs approved by the U.S. Food & Drug Administration. For more information, visit www.ctrc.net.