Advanced Prostate Cancer Rates Rising in Older US Men

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Los Angeles board-certified urologist Dr. Kia Michel discusses the increasing rate of advanced prostate cancer cases, which could be tied to a 2008 recommendation against PSA screening.

Kia Michel, MD - Board Certified Urologist

Kia Michel, MD - Board Certified Urologist

"Our duty as urologists is to make patients aware of all possible consequences of prostate diagnosis and treatment and then make an informed decision," said Dr. Michel

Nearly a decade after it was first recommended that men over the age of 75 should not undergo PSA (prostate-specific antigen) screening, the cancer screening continues to stir controversy. The US Preventative Services Task Force (USPSTF) issued a recommendation against PSA screening in 2008 because it found that the risks outweighed the benefits. Now, news from a study published in JAMA Oncology suggests that more men 75 and older are being diagnosed with advanced prostate cancer than before the recommendation.

“The 2008 recommendation was by no means met with universal approval by urologists and cancer specialists,” said Dr. Kia Michel of Comprehensive Urology in Los Angeles. “On one hand, there was and still is a lot of evidence showing that PSA screening results in over-diagnoses of prostate cancer. Yet, it’s still widely believed that PSA screening leads to detection of cancer in the prostate an average of at least five years earlier than without the screening.”

Researchers studied well over half a million men during a ten-year span ending in 2013 and found that in men younger than 75, there was a statistically insignificant rise in advanced, metastasized prostate cancer (2.7% to 4%). However, in men 75 and older, the increase was not insignificant (6.6% to 12%), as results showed in following the guidelines of the Surveillance, Epidemiology, and End Results collaborative staging (SEER staging). Interestingly, the USPSTF adjusted its recommendation against PSA screening in 2012 to include all men, not just those over the age of 75.

“These results could be explained partially by the fact that the recommendation against PSA screening in younger men was announced toward the end of the study,” Dr. Michel said. “In fact, the American Cancer Society published a report from a 2011-12 study showing a decline in early-stage prostate cancer diagnoses in men over 50. As such, I believe we need at least another 5-10 years of study on prostate cancer rates before we can really begin to interpret the numbers and understand the impact that no PSA screening has had on prostate cancer rates.”

The American Academy of Family Physicians (AAFP) suggests that doctors not offer or even request PSA screening without collaborating with their patients to make a shared, informed choice. Symptoms of prostate cancer are usually negligible or even non-existent, so men should see a urologist regularly for routine checkups and to discuss any questions or concerns they have about their prostate. To learn more about diagnostic screening and treatment options, visit http://Comprehensive-Urology.com/Prostate-Cancer/.

“I understand the evidence suggesting that PSA screening can lead to a diagnosis and treatment plan that is considered unnecessary by a large faction in the medical community,” Dr. Michel said. “However, our duty as urologists is to make patients aware of all possible consequences of diagnosis and treatment and then make an informed decision, especially with such a slow-growing tumor that often offers no noticeable symptoms. I would hate for an otherwise healthy, vibrant man over the age of 75 to see his prospects of enjoying another 10-20 years of life diminished because he didn’t have his prostate cancer diagnosed earlier due to the fact that his PSA screening exam came too late.”

Kia Michel M.D. earned his medical degree at the University of Washington School of Medicine and completed his residency at UCLA. He has also been recognized as a National Pfizer Scholar. As one of the founding members of the reputable Comprehensive Urology Medical Group, located in the Cedars-Sinai Medical Towers in Los Angeles, California, Dr. Michel treats a host of urological diseases. One of the few urologists who is both an acclaimed vaginal reconstructive and minimally invasive surgeon, Dr. Michel is a compassionate doctor who has dedicated his career to providing state-of-the-art care for his patients with a warm, nurturing touch.

Comprehensive Urology is a renowned urological practice in Los Angeles that provides state of the art urological care in a personalized and compassionate environment. The physicians at Comprehensive Urology are board-certified urologists with specialty training in a number of different aspects of urology and provide tailored care for their patients with outstanding results.

Call them today at (310) 499-2756 or visit their website: http://www.Comprehensive-Urology.com.

Comprehensive Urology
8631 W 3rd St #715e
Los Angeles, CA 90048
(310) 499-2756
CUInquiry(at)gmail(dot)com

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