Many Doctors Ignore Guidelines, Order PSA Tests for Elderly Men

By Steven Reinberg
HealthDay Reporter

TUESDAY, Oct. 15 (HealthDay News) — A new study finds that too many doctors ignore current guidelines that advise against giving PSA tests to elderly men, subjecting many of these patients to needless worry and bother.

Even though no major medical group currently recommends prostate-specific antigen (PSA) blood tests for men older than 75, more than 40 percent of the men covered in the new study were still being screened for prostate cancer in this way.

“Depending on which primary-care physician a man sees, he will be up to seven times more likely to receive the test than if he had seen a different primary-care physician,” said lead researcher Dr. Elizabeth Jaramillo, from the department of geriatrics at the Sealy Center on Aging at the University of Texas Medical Branch in Galveston.

The findings, published in the Oct. 16 issue of the Journal of the American Medical Association, are based on Medicare records for more than 61,000 patients and close to 2,000 primary-care doctors.

PSA testing is generally not recommended for men aged 75 and older because the vast majority of prostate cancers are so slow-growing that an elderly man is much more likely to die of another condition in his lifetime than from the cancer, Jaramillo said.

“When used in elderly men, the PSA test can lead to harms, including overdiagnosis,” she said. “Overdiagnosis is when someone who will live for a long period of time will get diagnosed and treated for a condition that normally would never cause symptoms or be detected in their lifetime.”

The treatment, perhaps including surgery, can be riskier than the disease and cause significant emotional stress. “We do not need to be screening elderly men for prostate cancer,” Jaramillo said.

It is estimated that more than 1 million excess prostate cancers have been identified from PSA testing, Jaramillo said.

At least one other expert disagreed with Jaramillo on the screening of elderly men, however.

Dr. Anthony D’Amico, chief of radiation oncology at Brigham and Women’s Hospital in Boston, said he thinks screening decisions should be based on a man’s overall health and life expectancy, not his age.

“According to the study, in patients with no

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