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Prostate screening test valuable for younger men, too

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Editor's note: The original version of this story incorrectly described the recommended screening procedure reported in the JAMA study. The study found that screening would be more effective if performed at age 40 and 45, then every two years beginning at age 50. The story below has been corrected.

ATLANTA, Georgia (CNN) -- A new study indicates that a popular blood test used to screen men over age 50 for prostate cancer may be just as valuable for younger men.

"Our model would suggest that, compared to testing at age 50, that for every 10,000 men screened, we would prevent one prostate cancer death," said Dr. H. Ballentine Carter, a study author and a urologist at Johns Hopkins School of Medicine in Baltimore, Maryland.

Reporting in the Journal of the American Medical Association, Carter and other researchers used computer modeling to predict the effectiveness of using the prostate-specific antigen blood test to screen younger men for cancer. They determined that screening would be more effective if done at age 40 and 45, then every two years beginning at age 50. Until now, the American Cancer Society had recommended that the test should be offered to all men yearly after age 50, or "younger" for those at high risk for the disease.

  TRANSCRIPT
  • Read a transcript of CNN.com's chat about prostate cancer with Dr. Robert Smith and Dr. Harmon Eyre of the American Cancer Society
  •  
      MORE
     
     Prostate cancer facts:
  • 1 in 10 American men will be diagnosed with prostate cancer during their lifetime, most after age 65.
  • This year alone, nearly 200,000 American men will learn they have prostate cancer. That's one new diagnosis every three minutes.
  • This year, prostate cancer will kill more than 30,000 men, making it the second-leading cause of cancer death.
  • Between 1973 and 1993, the rate of new prostate cancer cases rose by 173 percent, due in part to more widespread use of the PSA blood test, and in part because the population is aging.
  • African-American men have the highest incidence of prostate cancer in the world, as well as the highest mortality rates from the disease.
  • Asian men have the lowest incidence of prostate cancer.
  • Prostate cancer risk begins to increase after age 50 for white men who have no family history of the disease, and after age 40 for blacks and those who have close relatives who were diagnosed with the cancer.
  • The American Cancer Society and the American Urological Association recommend annual PSA screening tests and digital rectal exams for all men over age 50, and for all high-risk men beginning at age 40.

    Source: Two Against One

  • "There's increasing ... data that says if men get early detection for prostate cancer, the death rate in that population goes down," said Dr. Harmon Eyre, the society's chief medical officer.

    Based in part on the study's findings, and on other such data, the cancer society is adjusting its recommendations to say that men at high risk for the disease should be screened yearly beginning at age 45. Those at high risk include people who have had close family members diagnosed with prostate cancer, and African-American men.

    Blacks "have twice the rates of prostate cancer death as Caucasian men," said Eyre. "For reasons we don't know, it also starts at a younger age in African-American men."

    In addition, the society said information should be provided to patients regarding the risks and benefits associated with testing. Although the PSA test itself has little risk, there are consequences associated with prostate cancer treatment.

    'Two Against One'

    It is one of the few cancers where the treatment approach involves monitoring because more aggressive measures, such as surgery and radiation, can lead to impotence and incontinence. In the face of such possibilities, treatment options become difficult decisions, doctors say.

    "Women with breast cancer almost universally die from it within 10 years if they don't get treated," said Eyre. "It's quite different with prostate cancer. Many, if not most, men will live over 10 years with prostate cancer."

    A prostate cancer diagnosis also affects the whole family in a unique way, partly because of the sometimes-difficult adjustments to side effects from treatment.

    A new public education program called "Two Against One," spearheaded by New York Yankees manager and prostate cancer survivor Joe Torre and his wife, Alice, targets couples who are facing the threat together.

    "I think I was numb when I got the diagnosis," Torre said in a statement announcing the program. "I don't know what I would have done without Ali. She sought out information, asked questions and helped to guide us through the complicated process of reaching a treatment decision."

    "Two Against One" offers multimedia information, a Web site, a free booklet and a video, "Not By Myself," which features singers Billy Davis Jr. and Marilyn McCoo, who also successfully faced the disease.

    "Ali and I are very lucky to have each other," Torre said. "One of the reasons we want to talk about the 'couple effect' of prostate cancer is to encourage men to work with their spouses in fighting this disease, not shut them out."

    After his diagnosis, Torre said, there was a lot of information for him to try to absorb. "I knew if I missed something, Ali would get it," he added.

    Wives and family members also need support, said the Torres.

    Prostate cancer is second only to skin cancer as the most common cause of cancer diagnosis in men. It is men's second leading cause of cancer death.

    CNN Medical Correspondent Elizabeth Cohen contributed to this report.



    RELATED STORIES:
    Harvard researchers link prostate cancer and dietary calcium
    April 4, 2000
    Panel issues new guidelines on prostate cancer diagnosis
    February 21, 2000
    Selenium: New entry in fight against prostate cancer
    June 17, 1999

    RELATED SITES:
    Two Against One
    American Cancer Society -- Prostate Cancer Resource Center
    US TOO! International Inc., Support groups
    CancerNet: Prostate Cancer
    National Prostate Cancer Coalition


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