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News release from Beckman
Coulter:
Men Don't Get Full
Benefit of Prostate Cancer Test, Survey Finds Many men aren't
benefiting from a simple blood test for prostate cancer, because
their urologists aren't using the test to eliminate unnecessary
and expensive prostate biopsies.
That's the conclusion
based on results from a survey of American urologists attending
the American Urological Association's annual conference, held in
June in Anaheim, Calif. The survey was conducted by the Men's
Health Network (MHN), which released the results during National
Men's Health Week.
"The survey suggests
many doctors are not yet taking advantage of the risk-assessment
information that the free-PSA test provides about how likely
prostatic biopsies are to show cancers in individual cases,"
said a leading authority on prostate cancer testing, William J.
Catalona, M.D., of the Washington University School of Medicine.
"That means patients may not have all the information they
need to make an informed decision about whether or not to have a
biopsy."
Prostate biopsies
routinely cost more than $1,000, involve discomfort and anxiety,
and can cause complications such as infection, fever, urinary
retention and rectal bleeding.
"Doctors and
patients should be aware that in many cases, there is a readily
available alternative to prostate biopsy," said Tracie
Snitker, an MHN spokeswoman.
The free-PSA test is
FDA-approved and clinically proven to help detect prostate cancer
with great accuracy. Leading cancer researchers have concluded the
test can eliminate 20 percent of unnecessary biopsies, among men
who have moderately elevated levels of total PSA and a negative
digital rectal exam (DRE).
But the MHN survey found
most urologists do not perform a simple free-PSA blood test before
referring these men for biopsy.
American Cancer Society
guidelines clearly recognize the test's role in detecting cancer.
The guidelines say restricting biopsy "to men with less than
20 percent free-PSA improves testing accuracy," and that
proper use of the test "may result in a lower biopsy rate
compared with older strategies."
Nearly 90 percent of
urologists reported that when they recommend a prostate biopsy,
patients at least occasionally ask if there is an alternative.
Even though many
urologists do not perform a free-PSA blood test before referring
men with moderately elevated PSA levels for biopsy, most
urologists do nonetheless employ the test to assess these
patients' condition.
The large majority of
responding urologists recommends the test for men who have a
negative DRE and moderately elevated PSA levels, and especially
for men with moderately elevated PSA, a negative DRE and a
negative biopsy. "PSA is the best cancer tumor marker in all
of medicine, but there has been understandable pressure to improve
its accuracy," said Dr. Catalona. "Free-PSA is the best
available way to improve the accuracy of total PSA tests."
Dr. Catalona authored a
major study on the free-PSA test, establishing the test's role and
effectiveness in detecting cancer while eliminating unnecessary
biopsies.
A Men's Health Network
board member, David Gremillion, M.D., of the University of North
Carolina School of Medicine, praised PSA and free-PSA testing as
providing "an opportunity for men that can rival the benefits
of regular preventive care that women receive when they go for
their annual Pap smears and screening mammograms."
The survey of U.S.
urologists was performed by representatives of the Men's Health
Network from June 3-6, 2001. Beckman Coulter, which manufactures
the Hybritech free PSA test, provided an educational grant to
conduct the survey.
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