Limitations of Prostate Specific Antigen testing
From the deputy president of the Royal New Zealand College of General Practitioners,
Dr Jonathan Fox
1 April 2004
Men need educating about limitations of Prostate Specific Antigen testing
New Zealand men need educating about the limitations of the PSA test for detecting prostate Cancer, the College of GPs believes.
“Doctors must ‘First do no harm’ and there is
significant potential for harm in PSA testing for men
without symptoms,” College spokesman Dr Jonathan Fox
“We know the evidence is difficult to explain, but when men ask for the test, they need to know exactly what the difficulties can be.”
In its report to the Minister of Health on Prostate Cancer Screening in New Zealand, the National Health Committee noted no conclusive evidence that having a PSA test reduced deaths associated with prostate cancer. While not completely reliable a positive PSA test can set in train a cascade of intervention that may offer little benefit and have the potential to cause harm.
At the same time, the NHC noted concerns about the screening were not sufficient reason to deny the tests to a fully informed man who requests it.
Dr Fox said the College supported the report and its recommendations, which were based on scientific evidence.
“Men do need to realise this report is about the increasing incidence of PSA screening for men without symptoms. We must not confuse screening with investigating.
“If a man has symptoms, then we investigate.”
The information now available from both the NHC and the New Zealand Guidelines Group will allow men and their doctors to focus preventative care on screening programs that have proven benefit.