Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, January 25, 1995 TAG: 9501260061
SECTION: NATIONAL/INTERNATIONAL PAGE: A15 EDITION: METRO
SOURCE: ASSOCIATED PRESS
DATELINE: CHICAGO LENGTH: Medium
The test also had few false positives: It wrongly indicated that malignancies were present in only 9 percent of cancer-free men, researchers say in today's issue of The Journal of the American Medical Association.
The study underscores the value of the test, experts agree, but does not settle the most important question: Will screening older men lower the death rate from prostate cancer?
Prostate-specific antigen screening, or PSA, is controversial because it has led to almost a sixfold increase in the number of surgical prostate removals.
Such surgery often makes men impotent or incontinent and may not lengthen their lives, especially if they are elderly and the cancers are slow-growing. No study has yet shown that screening leads to greater cancer survival rates.
Dr. Peter H. Gann, lead author of the study, said a large clinical trial is needed to learn whether yearly PSA screening reduces death rates. The National Cancer Institute recently began such a trial with 37,000 men.
``In 10 years, we may have some answers from that. We may not,'' said Gann, an assistant professor at Northwestern University Medical School in Chicago. ``A lot of things can go wrong in those trials.''
For now, patients will have to wrestle individually with what kind of screening to seek. Both the American Cancer Society and American Urological Association recommend that all men older than 50 get yearly PSA screening and a rectal exam, Gann said.
The government has not made any recommendation about the use of PSA, though the Food and Drug Administration gave approval last August for using the test.
Prostate cancer is expected to strike 244,000 U.S. men this year and kill 40,400.
Dr. Gerald W. Chodak, a professor of surgery at the University of Chicago, said the study results are misleading because not all the cancers predicted by the PSA test would have been caught by a biopsy - always the follow-up to a positive PSA test.
by CNB