PSA tests - should they be routine.

That already exists in England and Wales. I think part of the problem with threads like this one is that people say 'screening' but mean something quite different. 

Well John, about 10 or so years ago there was held a large meeting where many interested groups, individuals, and professionals debated PSA testing and a motion that men aged 50 or earlier if in a more at risk category be PSA tested.  One of the eminent doctors opposing the motion was Chis Parker of The Royal Marsden who you have quoted as a leading light in another context. 

If I recall correctly it was called something like 'The Great PSA Debate'. I will try to find a link. It came as no surprise that there was a sizable majority in favour of testing.  However, on considering professional advice and doubtless also logistical and cost implications of testing at aged 50, the Government have not been persuaded to make the change and it seems most other countries have taken the same line. 

Edited by member 26 Jul 2020 at 15:28  | Reason: Not specified

This is what I was alluding to -

Dr Chris Parker, our final
speaker, oncologist from the Royal
Marsden, explained his own
personal view, which forces him to
reject the motion. He prefers to
accept a small increase in risk of
death through not knowing his
PSA rather than the very much
larger increase of risk of
unnecessary treatment. He
illustrated graphically how the
recent European trial had showed a
20% reduction in mortality, but at
expense of massive over-treatment.
He outlined a number of other risk
factors that would be more
effective than a screening
programme in reducing death
through early detection..

Extract from The Great PSA Debate

https://www.tackleprostate.org/uploads/files/ProstateMatters_7.pdf

Apart from improvements in MRI, we don't seem to have made significant progress in finding a better marker for testing than PSA in the years from 2009 and there are still some GP's who are very reluctant to authorise a PSA test for men at 50.

Edited by member 27 Jul 2020 at 05:23  | Reason: Not specified

I think the conclusions of the trial Chris Parker referred to in 2009 may have changed somewhat in that the benefit of screening was underestimated (see https://drcatalona.com/ for some discussions). Doesn't mean he changed his mind about universal screening though. 

I major problem seems to be that many GPs misunderstand the PSA testing controversy and ignore NICE guidelines, mine for example ignored my PSA of 5.68 (but referred me when it reached 32 six years on, when the lab noted "CALL PATIENT"), and the man I shared a hospital room with after my RP was initially refused a PSA test even though he had clear symptoms and various risk factors (he went to a different GP which likely saved his life). 

I was diagnosed at 56 with localised prostate cancer and have recently received my brachytherapy treatment, shortly after my diagnosis a 72 year old friend who I had told about my diagnosis went for tests, biopsy etc. and was told he had Gleason 4 +4 Prostate cancer where it has moved to his bones he would have loved to have been diagnosed early like me and seeing what he is going through I am glad I was diagnosed early and that all started with a PSA test.