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Prostate Screening: Older Men Don't Need It, But Still Get It


When 81-year-old billionaire investor Warren Buffett recently revealed he had been diagnosed with early-stage prostate cancer after a routine screening blood test, many health experts wondered why a man of his age was even being tested for prostate cancer.

Federal guidelines, issued in 2008, strongly advised against testing in men age 75 and older, saying it had little to no value.

Yet a new study finds that the number of older men receiving the prostate specific antigen (PSA) test has actually increased.

Researchers with the University of Chicago and the University of California, Los Angeles, found that men in their 70s and 80s are being tested more than men in their 40s and 50s.

In other words, doctors and patients have completely ignored the government's advice.

In 2008, the U.S. Preventive Services Task Force -- an independent panel of experts appointed by the U.S. Department of Health and Human Services -- recommended against PSA testing in men 75 and older, saying the benefits of treatment if cancer is detected are "small to none."

The task form found that the test can be unreliable in older men and when cancer is found, it typically is so slow-growing that it will never cause harm. Plus, treatment can cause its own harmful side effects, including pain, incontinence, bowel problems and impotence, among other risks.

Yet researchers found that two years after the recommendations, the screening rate for men older than 75 had increased from 43 percent to nearly 44 percent -- higher than the rates for men in their 40s (12.5 percent) or 50s (33.2 percent). Only men aged 60 to 74 were more likely to get screened, with 51.2 percent getting the PSA test.

"PSA screening for more than 40 percent of men 75 or older is inappropriate,"  study author Scott Eggener, M.D., assistant professor of surgery at the University of Chicago Medicine, said in a statement.

For a large majority of men in this age group, Eggener said, "early detection can lead to treatment of a disease that will probably never cause a problem. A substantial proportion of men over 75 with an elevated PSA will die from something else before a prostate cancer interferes with the quality or duration of their life."

The American Cancer Society and the American Urological Association recommend against PSA screening for men whose life expectancy is 10 years or less -- and talking about that may be part of the problem.

Otis Brawley, M.D., chief medical officer for the American Cancer Society, told the New York Times that doctors may give the test because they don't want to have a conversation with their patients about life expectancy.

"If you decide not to do the PSA, then you've got to have this conversation you really don't want to have with the patient," Brawley told the Times. "For doctors to do that, it is emotionally challenging. Talking to someone else about their mortality is really uncomfortable for doctors."

In other health news:

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Whole Foods to stop selling unsustainable seafood. The organic and natural foods grocery chain announced that it would stop selling wild-caught seafood from over-fished waters or captured through methods that harm other ocean life or habitats. Among the fish that the markets will no longer sell: Gray sole, Atlantic cod, turbot and Atlantic halibut. The Huffington Post has a slide show on the types of fish Whole Foods will no longer sell and why.

Old school kitchen tools -- 5 reasons to hold onto them. In an essay on the website, writer Susan Lutz gives five reasons to skip buying new gadgets and hang onto kitchen tools your grandma used. One big reason: Those heirloom tools are often made from stronger, safer materials.

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