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Men over 75 Urged to Skip Prostate Cancer Screening

Medical care for older men may change after a federal task force recommended Monday that men older than 75 not get screened for prostate cancer, the second-deadliest-type among males. A National Institutes of Health official presents the concerns behind the recommendation.

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    When is a screening test for cancer beneficial and when might it cause more harm than good? Doctors have been grappling with that for years in the case of prostate cancer, the most common type of cancer among American men and the second deadliest.

    Current guidelines from the American Cancer Society and the American Urological Association recommend a screening test be offered to most men over 50. But yesterday a federal task force recommended that doctors should stop routine screenings for men age 75 and older.

    To walk us through all this, we're joined by Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health. He's also involved with a major trial looking at screening for four cancers, including prostate.

    Welcome to you.

    DR. BARNETT KRAMER, National Institutes of Health: Thank you.


    Let's first step back and explain the PSA test that's under debate here. What does it do? And what are its limitations?


    The PSA stands for an enzyme that's called prostate-specific antigen. And the name is very helpful, that is, it is prostate-specific, not prostate-cancer-specific.

    So it is secreted from damaged cells in the prostate, whether it's a malignant condition or benign, and that's what makes interpretation of the test quite difficult.


    Meaning what?


    PSA can be leaks from any cells that are damaged. And that might be simple inflammation as occurs with a condition known as prostatitis, a benign condition. It can also come out of the prostate just with simple benign enlargement, benign prostatic hyperplasia.

    The majority of times when the PSA is elevated, in fact, is because of benign conditions rather than prostate cancer.

    However, because the level often goes up in the setting of prostate cancer — again due to damaged cells — it can indicate that a man has prostate cancer.