PSA testing for men at average risk of prostate cancer

Bruce K Armstrong, Michael J. Barry, Mark Frydenberg, Robert A Gardiner, Ian Haines, Stacy M. Carter

Research output: Contribution to journalComment / DebateOtherpeer-review

5 Citations (Scopus)

Abstract

Prostate-specific antigen (PSA) testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common - arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities - including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council - have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: Prostate cancer deaths prevented (a small and disputed number); prevention of metastatic disease (somewhat more common); and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again). A sizeable proportion of men diagnosed through PSA testing (somewhere between 20% and 50%) would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture.

Original languageEnglish
Article numbere2731721
Number of pages6
JournalPublic Health Research and Practice
Volume27
Issue number3
DOIs
Publication statusPublished - 26 Jul 2017

Cite this

Armstrong, Bruce K ; Barry, Michael J. ; Frydenberg, Mark ; Gardiner, Robert A ; Haines, Ian ; Carter, Stacy M. / PSA testing for men at average risk of prostate cancer. In: Public Health Research and Practice. 2017 ; Vol. 27, No. 3.
@article{ded57e447e3d4e9ba86a14f7e0a2390a,
title = "PSA testing for men at average risk of prostate cancer",
abstract = "Prostate-specific antigen (PSA) testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common - arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities - including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council - have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: Prostate cancer deaths prevented (a small and disputed number); prevention of metastatic disease (somewhat more common); and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again). A sizeable proportion of men diagnosed through PSA testing (somewhere between 20{\%} and 50{\%}) would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture.",
author = "Armstrong, {Bruce K} and Barry, {Michael J.} and Mark Frydenberg and Gardiner, {Robert A} and Ian Haines and Carter, {Stacy M.}",
year = "2017",
month = "7",
day = "26",
doi = "10.17061/phrp2731721",
language = "English",
volume = "27",
journal = "Public Health Research and Practice",
issn = "2204-2091",
publisher = "The Sax Institute",
number = "3",

}

PSA testing for men at average risk of prostate cancer. / Armstrong, Bruce K; Barry, Michael J.; Frydenberg, Mark; Gardiner, Robert A; Haines, Ian; Carter, Stacy M.

In: Public Health Research and Practice, Vol. 27, No. 3, e2731721, 26.07.2017.

Research output: Contribution to journalComment / DebateOtherpeer-review

TY - JOUR

T1 - PSA testing for men at average risk of prostate cancer

AU - Armstrong, Bruce K

AU - Barry, Michael J.

AU - Frydenberg, Mark

AU - Gardiner, Robert A

AU - Haines, Ian

AU - Carter, Stacy M.

PY - 2017/7/26

Y1 - 2017/7/26

N2 - Prostate-specific antigen (PSA) testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common - arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities - including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council - have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: Prostate cancer deaths prevented (a small and disputed number); prevention of metastatic disease (somewhat more common); and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again). A sizeable proportion of men diagnosed through PSA testing (somewhere between 20% and 50%) would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture.

AB - Prostate-specific antigen (PSA) testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common - arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities - including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council - have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: Prostate cancer deaths prevented (a small and disputed number); prevention of metastatic disease (somewhat more common); and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again). A sizeable proportion of men diagnosed through PSA testing (somewhere between 20% and 50%) would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture.

UR - http://www.scopus.com/inward/record.url?scp=85026752730&partnerID=8YFLogxK

U2 - 10.17061/phrp2731721

DO - 10.17061/phrp2731721

M3 - Comment / Debate

VL - 27

JO - Public Health Research and Practice

JF - Public Health Research and Practice

SN - 2204-2091

IS - 3

M1 - e2731721

ER -