Panel expected to say no prostate screenings for men

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Study: Men don't need prostate examsNEW: Prostate Cancer Foundation spokesman calls recommendation a mistakeNEW: But author of report says he believes testing does more harm than goodU.S. Preventive Services Task Force to give prostate specific antigen testing a "D" ratingIt says tests bring "small or no reduction" in prostate cancer deaths

(CNN) -- The U.S. Preventive Services Task Force, the group that told women in their 40s that they don't need mammograms, will soon recommend that men not get screened for prostate cancer, according to a source privy to the task force deliberations.

The task force is set to recommend a "D" rating for prostate specific antigen, or PSA, testing. Such a rating means "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," according to the group's website. The task force is set to propose this recommendation Tuesday, and then allow for a comment period before issuing a final recommendation.

According to a draft copy of a report released Friday, a review of studies shows screening with the PSA blood test results in "small or no reduction" in prostate cancer deaths.

The report adds that PSA testing is "associated with harms related to subsequent evaluation and treatments."

The PSA test, which is sometimes accompanied by a digital rectal exam, can help determine if a man has prostate cancer. The problem is that many of the cancers that get detected are so small and slow-growing, they'll never be harmful, and doctors have a difficult time discerning the quick, harmful cancers from the slow, harmless ones.

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If you test 100 men over age 50, 17 of them will have prostate cancer, and only three of those will have a fast-growing cancer and die of the disease, according to Dr. Kenneth Lin, senior author of the paper.

If the 14 men with the slow-growing cancers are treated, they could be rendered impotent or incontinent from the treatment; or worse, the treatment could kill them. About one in 500 men who has a radical prostatectomy will die because of complications of the surgery, according to Lin.

Some prostate cancer patients were disappointed with the task force's decision.

A spokesman for the Prostate Cancer Foundation called the proposed recommendation "a tremendous mistake."

"You're talking to someone whose life was saved by [the PSA test]," Dan Zenka said.

But Lin says he believes testing does more harm than good.

"Maybe you should get tested if you have this horrible family history where everyone gets prostate cancer before the age of 50. But for most men, testing is harmful," he said.

Until last year, Lin worked with the Preventive Services Task Force as a medical officer for the Agency for Healthcare Research and Quality. He says the task force voted in 2009 to give PSA screening a "D" rating, but it didn't announce it because of the uproar over the mammogram recommendation.

"I was so frustrated with the political interference, and this was the final straw," said Lin, who left the group in November and is now an assistant professor of family medicine at Georgetown University Medical Center.

CNN's Jennifer Bixler and Aaron Cooper contributed to this report.

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Panel Advises Against Routine Prostate Screening

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No major medical group recommends routine PSA blood tests to check men for prostate cancer, and now a government panel is saying they do more harm than good and healthy men should no longer receive the tests as part of routine cancer screening.

The panel's guidelines had long advised men over 75 to forgo the tests and the new recommendation extends that do-not-screen advice to healthy men of all ages.

The recommendation by the U.S. Preventive Services Task Force, being made public on Friday, will not come as a surprise to cancer specialists.

Yet, most men over 50 have had at least one PSA blood test, the assumption being that finding cancer early is always a good thing.

Not so, said Dr. Virginia Moyer of the Baylor College of Medicine, who heads the task force.

"We have put a huge amount of time, effort and energy into PSA screening and that time, effort and energy, that passion, should be going into finding a better test instead of using a test that doesn't work," Moyer told The Associated Press late Thursday.

Too much PSA, or prostate-specific antigen, in the blood only sometimes signals prostate cancer is brewing. It also can mean a benign enlarged prostate or an infection. Worse, screening often detects small tumors that will prove too slow-growing to be deadly. And there's no sure way to tell in advance who needs aggressive therapy.

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The task force analyzed all the previous research on this subject, including five major studies, to evaluate whether routine screening reduces deaths from prostate cancer. The conclusion: There's little if any mortality benefit.

But there is harm from routine screening: impotence, incontinence, infections, even death that can come from the biopsies, surgery and radiation, Moyer said.

One study estimated 2 of every 5 men whose prostate cancer was caught through a PSA test had tumors too slow-growing to ever be a threat.

Yet Moyer said 30 percent of men who are treated for PSA-discovered prostate cancer suffer significant side effects, sometimes death, from the resulting treatment.

About a third of men ages 40 to 60 have brewing prostate cancer but "the huge majority of them will never know it in their lifetime if they are not screened," she added.

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The task force previously had considered the evidence for or against PSA screening inconclusive. The new recommendation says not to routinely screen. That recommendation is a draft that is open for public comment beginning next week.

"We have been long concerned, and it has been apparent for some years, that some supporters of prostate cancer screening have overstated, exaggerated and in some cases misled men about the evidence supporting its effectiveness," said Dr. Otis Brawley of the American Cancer Society in a statement. "We need balanced, truthful information to be made widely available to physicians and patients when making important health decisions."

The society had not seen the new recommendation yet, but has long advised men to consider the pros and cons of PSA screening before deciding on their own.

Moyer said the recommendation only means that doctors shouldn't bring up the option for healthy men. If a man asks for a PSA test and wants it after being informed of the evidence, he should receive it, she said. Likewise, it's appropriate to use PSA tests to examine a man with possible prostate symptoms.

—By LAURAN NEERGAARD

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