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Re-activateLooking at previous heated discussions here on this topic, I think I'd better reach for my tin hat before outlining the results of a new study about the test.
It's clear that a raised level of PSA in the blood can be a sign of prostate cancer. But this study questions whether there's a good point at which we can say PSA is raised enough to investigate further. The study found that a very low level of PSA (below 1 ng/ml) pretty much rules out prostate cancer. That's great for men who get these results. But most men don't have levels this low.Most PSA tests use a cut-off level of 3 or 4 ng/ml, so that men with PSA at or above these levels need to have further investigations. This study shows that this system would miss a lot of men with prostate cancer (between one third and two thirds). It would also pick up a lot of men who didn't have cancer, sending them for further tests.
The researchers say there's just too much overlap in PSA levels between men with and without prostate cancer for it to be a useful test. Others say the test is all we have to raise concerns about prostate cancer before a man gets symptoms, so we should make use of it.
An analysis published along with the study raised a disturbing point. One third of men in the US who'd been tested for PSA didn't realize they'd had the test. That suggests some doctors don't take the trouble to talk about PSA with their patients before their blood is tested. Whatever your thoughts about the test, surely you'd want to be fully informed before you chose it?
What you need to know. Is any test better than no test for prostate cancer? Or should we leave men alone until we've got a better, more accurate test? Let us know if the latest research has changed your mind, by commenting below.—Anna Sayburn, patient editor, BMJ Group
ConsumerReportsHealth.org has partnered with The BMJ Group (British Medical Journal) to monitor the latest medical research and assess the evidence to help you decide which news you should use.
Prostate cancer is the most common cancer among men in the U.S. Find out if you or someone you know is at risk, learn about the symptoms, and take a look at 5 treatments for cancer that has not spread (subscribers only). And if you're being treated for enlarged prostate, find out how you can save money on your medication.
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