In a bizarre twist of Virginia hospital negligence, a recent study by the Journal of General Internal Medicine found that prostate screening in elderly patients may actually do more harm than good.
Can Prostate Screening Harm You?
The U.S. Preventive Services Task Force recommends that men over 75 years old should not be given the PSA screening test because potential harm (including false positive results and invasive or unnecessary medical treatment) will outweigh any benefits. However, principal investigator Louise C. Walter, MD, found that screening rates for elderly male patients ranged from 25 to 79 percent—even in cases of terminally ill patients.
Walter, MD, a geriatrician at SFVAMC and a professor of medicine at UCSF, discovered that roughly half of American men over age 85 or with four or more serious diseases received prostate-specific antigen (PSA) screening tests. The usual screening rate for men with limited life expectancy, according to the study’s authors, is between zero and 20 percent.
The study involved nearly 700,000 male patients receiving treatment at VA medical centers across the country. The authors are working to reduce inappropriate PSA screenings, but also to educate elderly patients so they can accurately assess the harms and benefits of testing.
While these screenings can save lives, the study found that frail seniors are more likely to suffer from the testing, so the screenings should be reserved for healthy older men. Some VA hospitals are screening up to four fifths of their very ill, very elderly patients…but none are targeting screening according to the men’s life expectancy,” Walter said. “Low or high, a hospital’s screening rate had nothing to do with whether the men were sick or well.”