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Smarter PSA Screening for Prostate Cancer
By Cara Adler
Raising the prostate-specific antigen threshold for biopsy referral in older men and screening less often in men with low PSA levels might improve the harm-benefit tradeoff of PSA screening for prostate cancer, according to an Annals of Internal Medicine study.
Researchers used a computer model to compare 35 screening strategies that varied in age to start and stop screening, screening interval, and PSA threshold for biopsy referral. Compared with standard screening, using a higher PSA threshold for biopsy referral in older men and longer screening intervals in men with low PSA levels would reduce the harms of screening (for example, overdiagnosis, unnecessary biopsy, and treatment) without lowering the number of lives saved.
A commentator writes that the results, "involving calculations that often differ by only a fraction of a percentage point, are not likely to change clinical practice."
Annals of Internal Medicine article (Free abstract)
Annals of Internal Medicine editorial (Subscription required)
Published in Physician's First Watch February 5, 2013
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