Since the inception of PSA testing in late 80s and more frequent use in the early to mid 90s, the mortality rate for prostate cancer has been reduced 40%. The term widespread use of the PSA test has been liberally used these days. How true is this “widespread” use?
1)The "real" evidence suggests that in spite of the expressed
"widespread" use of PSA testing only 41% of men age 50 or above admit having a PSA within the last year. Men age 50 to 64 had a worse score. Only 33.6% admitted to have a test within the last year. In men 65 and above the figure is 51.3%.
Source: Swan J, Breen N, Coates RJ, Rimer BK, Lee NC. Progress in cancer screening practices in the United States: results from the 2000 National Health Interview Survey. Cancer. 2003 Mar 15;97(6):1528-40. PMID: 12627518 [PubMed - indexed for MEDLINE]
2) More recently the Cancer Prevention Fellowship Program, Division of Cancer Prevention and Health Communication and Informatics Research Branch, Division of Cancer Control and Population Science, National Cancer Institute, Bethesda published that 44.8% of men ages 50 to 75 had never had a PSA test in their life.
3) “Among men reporting about
PSA testing, an estimated 16% of 40- to 49-year-old men and 49% of 50- to 79-year-old men had a PSA test in the past 2 years”
Ross LE, Berkowitz Z, Ekwueme DU
Use of the prostate-specific antigen test among U.S. men: findings from the 2005 National Health Interview Survey.
Cancer Epidemiol Biomarkers Prev 17(3):636-44
Hardly widespread use in my view...and in spite of that there have been 40% less men dying of PCa in the USA in the last 20 years. Why are still 30,000 men dying of PCa a year ? Because they are hugely over diagnosed and over treated? I think that in the long term, under diagnosed is very possible given the "not-so-wide use" of PSA testing
The views or opinions expressed here are my own and are not endorsed nor supported by any agency or institution. Ask your physician for medical advice.
DX at age 58 in 1992. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA Dec, 2012: <0.1 www.pcainaz.org