September 21, 2014
 
prostate cancer discovery  
   THE BRADY UROLOGICAL INSTITUTE • JOHNS HOPKINS MEDICINE

   A PUBLICATION OF THE PATRICK C . WALSH PROSTATE CANCER RESEARCH FUND
   Volume VI, Winter 2010

When Can You Stop Checking Your PSA?
   
 

We know when screening should start. All men, especially African American men, and men with a family history of the disease, should have their first PSA blood test, and digital rectal exam at age 40. This is to establish a man’s baseline PSA; this number, and how fast it changes, will determine how often he needs to come back for further screening. But when can a man stop getting his PSA checked?

“This has been a more difficult question to answer,” says urologist Edward M. Schaeffer, M.D., Ph.D., “and many urologists have made recommendations to patients with little hard data to go on.” In fact, many men in their late seventies and older continue to undergo PSA screening, and this could lead to unnecessary treatment and complications; men that age are more likely to die from something other than prostate cancer.

Many men in their late seventies
and older continue to undergo
PSA screening, and this could
lead to unnecessary treatment
and complications.

To begin to answer this question, urologists Schaeffer and H. Ballentine Carter, M.D., worked with investigators from the Baltimore Longitudinal Study of Aging. They studied the PSA measurements of more than 800 men as they aged, and found that for men over 75 with PSA less than 3 ng/ml, none died of prostate cancer and only one developed aggressive, high-risk prostate cancer. In contrast, men of all ages with a PSA of 3 or higher had a continually increasing risk of dying from prostate cancer. “Based on these fi ndings,” notes Schaeffer, “we believe that all men with a PSA higher than 3.0 should continued to be screened, and that men over age 75 with a PSA lower than 3.0 may choose, after consultation with their urologist, to discontinue PSA testing and be followed with exams and clinical histories. Our study suggests that men at an age of 75 to 80 years who have a PSA level below 3 are unlikely to be diagnosed with a high-risk prostate cancer.”

Bottom Line:

When to Say Goodbye to PSA Testing? Of men over 75 with PSA less than 3, none died of prostate cancer and only one developed aggressive, high-risk prostate cancer.

In contrast, men of all ages with a PSA of 3 or higher had a continually increasing risk of dying from prostate cancer.

   


 

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