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VA RESEARCHERS FIND AN INCREASE IN PSA TESTING FOR

PROSTATE CANCER -- Many physicians are ordering

prostate-specific antigen, PSA, testing at an increasing

rate despite any clear evidence of the test's benefit.

For more information about veterans and prostate health, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=prostate&op=and

Story here... http://www.emaxhealth.com/33/19409.html

Story below:

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Researchers Find An Increase In Prostate Specific Antigen Testing

Researchers affiliated with Brigham and Women's Hospital (BWH), the Veterans Affairs Boston Healthcare System (VA) and the Harvard School of Public Health (HSPH) found that many physicians are ordering prostate-specific antigen (PSA) testing at an increasing rate despite any clear evidence of the test's benefit.

The greatest increases are among younger men, black men and those who have insurance.

These findings appear in the December 10, 2007 issue of Archives of Internal Medicine.

PSA is a protein produced by the cells of the prostate gland that is used by many physicians to screen for prostate cancer. To date, no studies have found that men screened by the PSA test survive longer than men who are not. While the test detects some prostate cancers early, it also leads to many false positives, subjects men to needless invasive tests and leads to substantially higher healthcare costs. As a result, most medical societies do not recommend screening all men with the test.

In this study, the researchers examined the National Ambulatory Medical Care Survey that collected data regarding visits to primary care physicians by healthy men aged 35 years or older. They found that between 1995 and 2004, primary care physicians were 50 percent more likely to order PSA tests during a typical clinic visit and nearly three times as likely to order a test during a preventive general medical exam. Specifically, PSA testing rates increased 8 percent per year during all primary care visits and 14 percent per year during visits for general medical examinations.

The researchers noted that prostate cancer screening is now more common than colorectal cancer screening, although the evidence for prostate cancer screening practice is much weaker.

"We expected to find an increase in PSA testing over the years, but were surprised to see such an increase among younger men aged 35 to 49 because the test is not widely recommended for these men," said Wildon R. Farwell, MD, who is a physician in the Division of Aging at BWH.

The researchers explained that the overall increase in PSA testing may be the result of several factors, which include greater patient awareness leading to increased requests for prostate cancer screening and greater belief among physicians that this test is a useful way to screen for prostate cancer. Another possible explanation is that physicians may be ordering more testing because of perceived protection from malpractice suits.

"Until we know PSA testing is effective in reducing deaths associated with prostate cancer among men of any age, we should be more judicious with this test," said Ashish Jha, MD, MPH, a physician in the Department of General Medicine and Primary Care at BWH and an assistant professor at HSPH.

"The hope is that the results from two PSA testing trials, which are expected in 2009, will help physicians understand how to best optimize prostate cancer prevention services," added Farwell, who is also a physician at the VA.

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Larry Scott  --

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