Panel urges lower cutoff for child lead poisoning

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In this Thursday, Feb. 23, 2006 photo, contractors Luis Benitez, foreground, and Jose Diaz, background, clean up lead paint in a contaminated building in Providence, R.I. A federal panel recommended Wednesday, Jan. 4, 2012 that the threshold for lead poisoning in children should be lowered. If adopted by government officials, hundreds of thousands of additional U.S. children could be classified as having lead poisoning. Recent research persuaded panel members that children could suffer harm from concentrations of lead lower than the old standard, Centers for Disease Control and Prevention officials said. (AP Photo/Chitose Suzuki) In this Thursday, Feb. 23, 2006 photo, contractors Luis Benitez, foreground, and Jose Diaz, background, clean up lead paint in a contaminated building in Providence, R.I. A federal panel recommended Wednesday, Jan. 4, 2012 that the threshold for lead poisoning in children should be lowered. If adopted by government officials, hundreds of thousands of additional U.S. children could be classified as having lead poisoning. Recent research persuaded panel members that children could suffer harm from concentrations of lead lower than the old standard, Centers for Disease Control and Prevention officials said. (AP Photo/Chitose Suzuki)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); ATLANTA (AP) — For the first time in 20 years, a federal panel is urging the government to lower the threshold for lead poisoning in children.

If adopted, hundreds of thousands more children could be diagnosed with lead poisoning. Too much lead is harmful to developing brains and can mean a lower IQ.

Recent research persuaded panel members that children could be harmed from lead levels in their blood that are lower than the current standard, officials at the Centers for Disease Control and Prevention said.

While the number of cases has been falling, health officials think as many as 250,000 children have the problem, many of those undiagnosed. The proposed change could take it to 450,000 cases.

Wednesday's vote by the Advisory Committee on Childhood Lead Poisoning Prevention would lower the definition of lead poisoning for young children from 10 micrograms of lead per deciliter of blood to 5 micrograms. The CDC has accepted all of the panel's recommendations in the past.

Lead — a metal that for years was common in paint and gasoline — can harm a child's brain, kidneys and other organs. High levels in the blood can cause coma, convulsions and death. Lower levels can reduce intelligence, impair hearing and behavior and cause other problems.

Usually, the victims are children living in old homes that are dilapidated or under renovation, who pick up paint chips or dust and put it in their mouths. Lead has been banned in paint since 1978. Children have also picked up lead poisoning from soil contaminated by old leaded gasoline, and from dust tracked in from industrial worksites.

Lead poisoning is detected through a blood test, often when kids are toddlers. Most cases are handled by seeking out and removing the lead source, and monitoring the children to make sure lead levels stay down. A special treatment to remove lead and other heavy metals is used for very high levels.

But the problem has seemed to be diminishing, based on the old standard. In 2009, researchers reported that 1.4 percent of young children had elevated lead levels in their blood in 2004, the latest data available. That compares with almost 9 percent in 1988.

The lead poisoning threshold was last changed in 1991. The proposed level of 5 micrograms was calculated from the highest lead levels seen in a comprehensive annual U.S. health survey. The panel recommended that it be reassessed every four years.

"It's a moving target," said Perry Gottesfeld, co-chair of the group that came up with the advice.

Some groups celebrated the decision, saying medical evidence has been mounting that lower levels of lead poisoning can erode a child's ability to learn and cause behavior problems.

"This is long overdue," said Ruth Ann Norton, executive director of the Coalition to End Childhood Lead Poisoning, a Baltimore-based organization.

The recommendation might be difficult to implement. In many places, it's up to city and county health departments to provide many of the services for lead poisoned kids, and those departments have lost more than 34,000 jobs in the last three years because of budget cuts. Meanwhile, Congress just slashed the CDC's lead program from more than $30 million to $2 million.

"The CDC should accept the recommendation," said Robert Pestronk, executive director of the National Association of County and City Health Officials.

"(But) the grim reality is that local health departments and other community agencies don't have the person-power to identify and follow up on all these children," he said.

The panel's Gottesfeld acknowledged the challenge the new recommendations may pose.

"It's certainly going to put a great strain on local departments," he said.

___

CDC: http://www.cdc.gov/nceh/lead/

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Panel: Boys should get HPV vaccine given to girls

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FILE - In this Monday, Aug. 28, 2006 file photo, a doctor holds the human papillomavirus vaccine Gardiasil in his hand at his Chicago office. The controversial HPV shot given to girls should also be given to boys, in part to help prevent the spread of the virus through sex, a government medical panel said Tuesday, Oct. 25, 2011. (AP Photo/Charles Rex Arbogast) FILE - In this Monday, Aug. 28, 2006 file photo, a doctor holds the human papillomavirus vaccine Gardiasil in his hand at his Chicago office. The controversial HPV shot given to girls should also be given to boys, in part to help prevent the spread of the virus through sex, a government medical panel said Tuesday, Oct. 25, 2011. (AP Photo/Charles Rex Arbogast)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); ATLANTA (AP) — A vaccine against cervical cancer hasn't been all that popular for girls. It may be even a harder sell for boys now that it's been recommended for them too.

A government advisory panel on Tuesday decided that the vaccine should also be given to boys, in part to help prevent the cancer-causing virus through sex.

Public health officials have tried since 2006 to get parents to have their daughters vaccinated against the human papillomavirus, or HPV, which causes most of the cervical cancer in women.

They have had limited success, hitting a number of hurdles. Some parents distrust the safety of vaccines, especially newer products. Others don't want to think about their daughters having sex one day, or worry that the vaccine essentially promotes promiscuous behavior.

Tuesday's vote by the Advisory Committee on Immunization Practices' was the first to strongly recommend routine vaccination for boys since the vaccine was first approved for them two years ago. Officials acknowledged the low rate in girls encouraged them to take a new, hard look.

Experts say a key benefit of routinely vaccinating boys could be preventing the spread of the virus to others through sex — making up somewhat for the disappointing vaccination rate in girls. But the recommendation is being framed as an important new measure against cancer in males.

"Today is another milestone in the nation's battle against cancer," said Dr. Anne Schuchat, a U.S. Centers for Disease Control and Prevention administrator who oversees the agency's immunization programs.

Federal health officials usually adopt the panel's recommendations and ask doctors and patients to follow them.

The vaccine has been advised for girls since 2006. Just 49 percent of adolescent girls have gotten at least the first of the three HPV shots. Only a third had gotten all three doses by last year.

"Pretty terrible," Schuchat said.

Schuchat attributed the low rates for girls to confusion or misunderstanding by parents that they can wait until their daughter becomes sexually active. It works best if the shots are given before a girl or boy begins having sex.

Some conservatives argue the vaccine could promote promiscuous behavior. It has come up in the GOP presidential campaign. Texas Gov. Rick Perry came under attack for a 2007 executive order requiring adolescent girls to get the vaccine (with an opt-out clause). When conservative lawmakers rebelled, he backed down.

An estimated 75 to 80 percent of men and women are infected with HPV during their life, but most don't develop symptoms or get sick, according to the CDC. Some infections lead to genital warts, cervical cancer and other cancers, including of the head and neck.

The HPV vaccine is approved for use in males and females ages 9 to 26; it is usually given to 11- and 12-year olds when they get other vaccines. The committee also recommended that males 13 to 21 years get vaccinated.

Tuesday's vote follows recent studies that show the vaccine prevents anal cancer in males, and may work against a type of throat cancer. A study that focused on gay men found it to be 75 percent effective against anal cancer.

While anal cancer has been increasing, it's still fairly rare. Only about 7,000 U.S. cases in men each year are tied to the strains targeted in the HPV vaccine. In contrast, about 15,000 vaccine-preventable cervical cancers in women occur annually.

Preventing a cancer that's primarily associated with gay men may not be much of a selling point, said Dr. Ranit Mishori, a family practice doctor in Washington, D.C. and an assistant professor at the Georgetown University School of Medicine.

Some parents may say "'Why are you vaccinating my son against anal cancer? He's not gay! He's not ever going to be gay!' I can see that will come up," said Mishori, who supports the panel's recommendation.

Schuchat indicated the CDC is ready for that kind of argument: "There's no data suggesting that offering a vaccine against HPV will change people's subsequent sexual behavior," she said.

So far, the threat of genital warts hasn't been persuasive: Some data suggest that less than 1.5 percent of adolescent males have gotten the vaccine over the past two years.

Meanwhile, some feel it's unlikely that most parents will agree to get their sons vaccinated primarily to protect girls. A survey of 600 pediatricians last year found that nearly 70 percent of doctors thought families would deem vaccination of their boys as unnecessary.

Experts at the committee meeting noted an earlier analysis that showed vaccinating boys would not be cost-effective if the female vaccination were high.

"If you do reach high coverage of females, will you stop vaccinating males?" asked Dr. David Salisbury, director immunization for the United Kingdom's Department of Health.

There are two vaccines against HPV, but Tuesday's vote applies only to Merck & Co.'s Gardasil, which costs $130 a dose. The other vaccine wasn't tested for males.

The committee's recommendation — and the greater insurance coverage of the vaccine that is expected to follow — will make it easier for more boys to get the shots, said Dr. Mark Feinberg, chief public health and science officer for Merck Vaccines.

Merck officials bristled at the idea that males would see the vaccine as mainly meant for gay men, noting that HPV-caused anal cancers can occur in heterosexual men.

Maura Robbins of Chicago said she's likely to have her 12-year-old son, Cole, vaccinated against HPV — but probably not until he's a little older. "I would just like to see some long-term testing and long-term results," she said.

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

___

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HPV info: http://www.cdc.gov/hpv/

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Government Panel Recommends HPV Vaccine for Boys

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A federal advisory committee voted on Tuesday to recommend that boys aged 11 and 12 be vaccinated against human papillomavirus, or HPV, to protect against anal cancer and cancers of the mouth and neck. The new guidance mirrors that for girls aged 11 and 12, who have been advised since 2006 to receive routine HPV vaccinations.

The HPV vaccine is already approved by the government for males aged 9 to 26 to prevent genital warts and anal cancer, but the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) had not issued a formal recommendation for routine vaccination in boys until now.

In part, that's because when the vaccine was approved for use in boys and men in 2009, there wasn't enough evidence to justify the cost of population-wide vaccination. The HPV vaccine is expensive, costing hundreds of dollars for the three-dose series.

Since 2009, however, studies have provided additional information on the benefits of vaccinating boys, helping to lead to the ACIP's current, unanimous decision. In February, for example, researchers reported that the HPV vaccine prevented 90% of genital warts in men who were not infected with the virus before immunization. The vaccine was also found to be 75% effective in protecting against anal cancer in a study of primarily gay men. There is also early evidence that it protects against certain penile and throat cancers, and recent data suggest that HPV is increasingly responsible for some mouth and throat cancers, which have been on the rise — probably because of increasing rates of oral sex.

With 20 million Americans infected with HPV each year, the new recommendations for boys will be an important part of cancer prevention in coming years, according to public health expert. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases told reporters that "Today is another milestone in the nation's battle against cancer."

MORE: HPV Linked to More Oral Cancer Than Smoking

Now that the CDC's committee has officially recommended the vaccine for boys, most private insurers are likely to start paying for it.

HPV infection is the most common sexually transmitted disease in the U.S. Most sexually active men and women will acquire the virus at some point in their lives. In most people, infections will clear on their own, but in some, persistent infections can cause genital warts or cancer, including cervical, vaginal and vulvar cancers in women and anal cancer in men. The most widely used HPV vaccine, Gardasil, manufactured by Merck — to which the ACIP recommendation applies — is designed to protect against the four high-risk strains of the virus that contribute to warts and cancer.

For the most part, the ACIP's advice for vaccination in boys involves the same reasoning behind the recommendation for girls aged 11 to 12: that immunizing youngsters as part of routine childhood vaccination programs — despite the fact that they are not necessarily sexually active or at high risk of HPV infection — ensures that more people will be protected against HPV early on.

Of course, the issue of sexual activity has been the sticking point for many parents of youngsters who are eligible for the vaccine. That concern is largely responsible for low vaccination rates in girls. Despite the data showing that the HPV vaccine prevents cancer, only 44% of girls aged 13 to 17 had received one dose of the vaccine, and only 27% had received all three doses in 2009. The vaccine is supposed to be given before girls become sexually active.

MORE: With the HPV Vaccine, Two Doses May Be Just as Good as Three

The low vaccination rates in girls help justify the cost of vaccination in boys. If more males are protected, then they will be less likely to pass the virus to females. "If the boys are also immunized, it reduces the transmission back and forth," Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine, who attended the CDC meeting as an adviser but not a voting member, told CNN.

However, some experts expect the vaccine to be an even tougher sell in boys than in girls, in part because anal cancer is relatively rare in men and because most cases are in homosexual men. Some parents may say, "'Why are you vaccinating my son against anal cancer? He's not gay! He's not ever going to be gay!' I can see that will come up," Dr. Ranit Mishori, a family practice doctor in Washington, D.C., and an assistant professor at the Georgetown University School of Medicine, who supports the ACIP's recommendation, told the AP.

For its part, the American Academy of Pediatrics included the HPV vaccine in its schedule of routine vaccinations for 9-to-18-year-olds, released in February.

MORE: Vaccine Safety: New Report Finds Few Adverse Events Linked With Vaccines

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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Panel: Boys should get HPV vaccine given to girls

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FILE - In this Monday, Aug. 28, 2006 file photo, a doctor holds the human papillomavirus vaccine Gardiasil in his hand at his Chicago office. The controversial HPV shot given to girls should also be given to boys, in part to help prevent the spread of the virus through sex, a government medical panel said Tuesday, Oct. 25, 2011. (AP Photo/Charles Rex Arbogast) FILE - In this Monday, Aug. 28, 2006 file photo, a doctor holds the human papillomavirus vaccine Gardiasil in his hand at his Chicago office. The controversial HPV shot given to girls should also be given to boys, in part to help prevent the spread of the virus through sex, a government medical panel said Tuesday, Oct. 25, 2011. (AP Photo/Charles Rex Arbogast)eval("var currentItemd57851005a80479aaeeb90a12c70b9ff = 1;");eval("var nextd57851005a80479aaeeb90a12c70b9ff = 0;");eval("var previousd57851005a80479aaeeb90a12c70b9ff = 0;"); ATLANTA (AP) — A vaccine against cervical cancer hasn't been all that popular for girls. It may be even a harder sell for boys now that it's been recommended for them too.

A government advisory panel on Tuesday decided that the vaccine should also be given to boys, in part to help prevent the cancer-causing virus through sex.

Public health officials have tried since 2006 to get parents to have their daughters vaccinated against the human papillomavirus, or HPV, which causes most of the cervical cancer in women.

They have had limited success, hitting a number of hurdles. Some parents distrust the safety of vaccines, especially newer products. Others don't want to think about their daughters having sex one day, or worry that the vaccine essentially promotes promiscuous behavior.

Tuesday's vote by the Advisory Committee on Immunization Practices' was the first to strongly recommend routine vaccination for boys since the vaccine was first approved for them two years ago. Officials acknowledged the low rate in girls encouraged them to take a new, hard look.

Experts say a key benefit of routinely vaccinating boys could be preventing the spread of the virus to others through sex — making up somewhat for the disappointing vaccination rate in girls. But the recommendation is being framed as an important new measure against cancer in males.

"Today is another milestone in the nation's battle against cancer," said Dr. Anne Schuchat, a U.S. Centers for Disease Control and Prevention administrator who oversees the agency's immunization programs.

Federal health officials usually adopt the panel's recommendations and ask doctors and patients to follow them.

The vaccine has been advised for girls since 2006. Just 49 percent of adolescent girls have gotten at least the first of the three HPV shots. Only a third had gotten all three doses by last year.

"Pretty terrible," Schuchat said.

Schuchat attributed the low rates for girls to confusion or misunderstanding by parents that they can wait until their daughter becomes sexually active. It works best if the shots are given before a girl or boy begins having sex.

Some conservatives argue the vaccine could promote promiscuous behavior. It has come up in the GOP presidential campaign. Texas Gov. Rick Perry came under attack for a 2007 executive order requiring adolescent girls to get the vaccine (with an opt-out clause). When conservative lawmakers rebelled, he backed down.

An estimated 75 to 80 percent of men and women are infected with HPV during their life, but most don't develop symptoms or get sick, according to the CDC. Some infections lead to genital warts, cervical cancer and other cancers, including of the head and neck.

The HPV vaccine is approved for use in males and females ages 9 to 26; it is usually given to 11- and 12-year olds when they get other vaccines. The committee also recommended that males 13 to 21 years get vaccinated.

Tuesday's vote follows recent studies that show the vaccine prevents anal cancer in males, and may work against a type of throat cancer. A study that focused on gay men found it to be 75 percent effective against anal cancer.

While anal cancer has been increasing, it's still fairly rare. Only about 7,000 U.S. cases in men each year are tied to the strains targeted in the HPV vaccine. In contrast, about 15,000 vaccine-preventable cervical cancers in women occur annually.

Preventing a cancer that's primarily associated with gay men may not be much of a selling point, said Dr. Ranit Mishori, a family practice doctor in Washington, D.C. and an assistant professor at the Georgetown University School of Medicine.

Some parents may say "'Why are you vaccinating my son against anal cancer? He's not gay! He's not ever going to be gay!' I can see that will come up," said Mishori, who supports the panel's recommendation.

Schuchat indicated the CDC is ready for that kind of argument: "There's no data suggesting that offering a vaccine against HPV will change people's subsequent sexual behavior," she said.

So far, the threat of genital warts hasn't been persuasive: Some data suggest that less than 1.5 percent of adolescent males have gotten the vaccine over the past two years.

Meanwhile, some feel it's unlikely that most parents will agree to get their sons vaccinated primarily to protect girls. A survey of 600 pediatricians last year found that nearly 70 percent of doctors thought families would deem vaccination of their boys as unnecessary.

Experts at the committee meeting noted an earlier analysis that showed vaccinating boys would not be cost-effective if the female vaccination were high.

"If you do reach high coverage of females, will you stop vaccinating males?" asked Dr. David Salisbury, director immunization for the United Kingdom's Department of Health.

There are two vaccines against HPV, but Tuesday's vote applies only to Merck & Co.'s Gardasil, which costs $130 a dose. The other vaccine wasn't tested for males.

The committee's recommendation — and the greater insurance coverage of the vaccine that is expected to follow — will make it easier for more boys to get the shots, said Dr. Mark Feinberg, chief public health and science officer for Merck Vaccines.

Merck officials bristled at the idea that males would see the vaccine as mainly meant for gay men, noting that HPV-caused anal cancers can occur in heterosexual men.

Maura Robbins of Chicago said she's likely to have her 12-year-old son, Cole, vaccinated against HPV — but probably not until he's a little older. "I would just like to see some long-term testing and long-term results," she said.

___

AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

___

Online:

HPV info: http://www.cdc.gov/hpv/

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U.S. Panel Urges 'Energy Star' Nutrition Ratings for Food Labels

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Taking a cue from the Energy Star ratings on the front of household appliances, a panel of experts is recommending that a similarly easy-to-read system appear on every packaged food item in American grocery stores so busy consumers can glean nutritional info at a glance.

The recommendation comes from the Institute of Medicine (IOM), which was commissioned by Congress to study the issue over the past two years. The panel found that the dizzying variety of front-of-pack labels currently out there — grocery stores, food manufacturers and even health organizations like the American Heart Association put their own stamps on various foods — was leading to more consumer confusion than healthy choices.

Part of the problem is that food manufacturers like to tout their products' pluses (high in vitamin A) on the front of the box, without acknowledging their minuses (high in fat).

The IOM reviewed front-of-package labeling systems in the U.S. and abroad (here's a good rundown of labels) and found that, in terms of clarity for the consumer, no system was better than the next. So the panel proposed a standard label for all products that would show how many calories per serving the food item contains, along with a three-point system (checkmarks or stars) that would indicate whether the product contains acceptable levels of sodium, added sugars and trans fats or saturated fats.

Items would get a point each for having low enough levels of each of the three nutrients "of concern" — which the panel chose for being most closely associated with health problems like obesity, diabetes and heart disease — for a maximum of three points. If a product has a superhigh amount of any of the nutrients, rendering it unhealthy overall, it would receive no points. So sugary soda, for example, would get zero points for having high added sugar, even though it is low in fats and sodium.

Whole wheat bread would get three points, while graham crackers would get two (low levels of fats and sodium, but high in added sugar), and soup crackers would get zero. The hope is that the point system will not only help consumers cut through the culinary clutter and make fast, smart decisions, but also inspire grocers to encourage the sales of high-point foods and encourage manufacturers to reformulate their foods in pursuit of points.

During a meeting with media on Thursday, Ellen Wartella, the chair of the IOM panel and a professor of psychology at Northwestern University, explained that the system was meant to be interpretive more than informational. So, even shoppers with no nutritional knowledge and those who are too rushed to analyze the Nutrition Facts panel on the side of the box can still identify healthy products in a split-second effort. It's the difference between "This has 100 grams of saturated fat" and "Eating this is not going to do you any favors."

The panel explained that a front-of-pack label that focuses on best-to-avoid nutrients, rather than those that should be encouraged like, say, fiber and potassium, is a reflection of public need. Americans are eating too much fat, sugar and sodium, and at a time when two-thirds of the population is overweight or obese and many are battling diet-related health problems like heart disease and Type 2 diabetes, the government's most important role should be in guiding people away from unhealthy foods, the panel advised. (Certainly a far cry from the World War II days, when the government recommended that the underfed population consider butter its own food group.)

The IOM's point system leads to some awkward ratings, however. A Diet Coke, for example, would get three points for having low levels of fats, added sugars and sodium. Meanwhile, 1% milk would get only two points, due to its fat content. But with that fat, of course, come good nutrients that an empty diet soda doesn't provide.

The process is still in its early stages. It's unclear whether federal regulators will adopt the new labels or whether they will be mandatory — though the project would make more sense if they were. Part of the justification for recommending a single, uniform system is that all products will be easily comparable. And allowing it to be voluntary would potentially remove many points of comparison.

For its part, the Grocery Manufacturers of America, an industry group that represents food makers, said it would go ahead with its own voluntary system of package-front labeling called Facts Up Front. That system lists calories, fat, sodium and sugar, as well as beneficial nutrients like fiber. It gives information, but doesn't rate products. "We believe the most effective programs are those that trust consumers and not ones that tell consumers what they should and should not eat," Scott Faber, a lobbyist for the Grocery Manufacturers Association, told the AP.

The next step is for the Food and Drug Administration (FDA) to decide whether or how to implement the panel's recommendation. The FDA is keen to overhaul front-of-package labeling, but the agency is continuing to study the matter.

Good promotion, the IOM panel noted, would also be key to any program's success. And the proposed three-point system would be an easy sell to consumers. All they need to understand is that "three is better than two, and two is better than one," said Matt Kreuter, a professor of social work and medicine at Washington University and a member of the panel. "And the more points it has, the healthier it is."

Katy Steinmetz is a reporter at TIME. Find her on Twitter at @KatySteinmetz. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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PSA test for prostate cancer not recommended: panel

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By Julie Steenhuysen

CHICAGO | Fri Oct 7, 2011 1:43pm EDT

CHICAGO (Reuters) - A U.S. government-backed panel recommended against routine prostate cancer screening on Friday because widespread screening for the disease causes more harm than good.

The U.S. Preventive Services Task Force had previously said there was not enough evidence to make a call on the use of prostate-specific antigen, or PSA, tests that measure levels in the blood of a protein.

The same panel caused a media storm in 2009 after it recommended doctors scale back on routine mammograms for women in their 40s and 50s.

The panel, which advises the government on health prevention measures, downgraded its recommendation on prostate cancer screening to a "D," which means it recommends against the service because "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits."

The proposed guidelines are meant to discourage use of the test for healthy men who do not have any symptoms that might indicate prostate cancer. They do not apply to the use of PSA tests as part of a diagnostic strategy in men suspected of having prostate cancer.

High or increasing levels of PSA can indicate an increased risk for prostate cancer, but elevated PSA levels can be caused by other things too, such as infections, an enlarged prostate or even recent ejaculation.

Studies have shown that widespread use of PSA tests has resulted in high rates of false positives and overtreatment for an often slow-growing cancer that might never have caused harm.

And the treatments -- usually surgery and radiation -- are not benign. They frequently result in impotence and incontinence.

Simply being diagnosed with prostate cancer can cause anxiety and harm. A study by researchers at Harvard and Brigham & Women's Hospital in Boston last year found that being diagnosed with prostate cancer roughly doubles the risk of suicide or death from a heart attack.

MIXED RESULT ON PSA TEST EFFECTIVENESS

But prostate cancer is not harmless. It is the second-leading cause of cancer death in the United States behind lung cancer.

"The notion that prostate cancer is not a threat to the well being of men is simply wrong," said Dr. Herbert Lepor, a urology professor at New York University School of Medicine.

Results of studies looking at the benefits of widespread prostate cancer screening have been mixed, according to the conclusions of a review of studies set to be published next week but released early by the Annals of Internal Medicine.

That review, which is used by the task force to make its recommendations, noted that of the five screening trials it studied, the two largest and highest-quality studies reported conflicting results. One found screening was associated with reduced prostate cancer deaths compared with no screening in men age 55 to 69 after nine years.

The other found no statistically significant benefit after 10 years. And of the men who had three or four rounds of screening, the false positive rate was 12 to 13 percent.

"Prostate-specific antigen-based screening results in small or no reduction in prostate cancer-specific mortality and is associated with harms related to subsequent evaluation and treatments, some of which may be unnecessary," the report concluded.

But critics say the studies were not long enough to show a benefit and argued that there is evidence that PSA screening saves lives.

"The U.S. Preventive Services Task Force claims the screening studies fail to show benefits of screening. This is not accurate," Lepor said.

A Scandinavian study with 14 years of follow up showed prostate cancer screening cut prostate cancer deaths by 50 percent, Lepor said.

"The U.S. Preventive Services Task Force is a group of primary care physicians like pediatricians and OB/GYNs who never treat prostate cancer. They have simply misinterpreted the studies and have not seen men die of this fatal disease," Lepor said.

The guidelines had been scheduled to be released in the Annals of Internal Medicine on Monday, but leaks of the recommendations to news outlets forced the group to post the guidelines early. It was first reported by CNN on Thursday.

The recommendations will be available for a 30-day comment period before final treatment guidelines are released.

According to the American Cancer Society, about 1 man in 6 will be diagnosed with prostate cancer during his lifetime. More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

(Editing by Jackie Frank)

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