Life Extension Magazine®

Doctor sharing the results of a PSA screening with their patient

As We See It: Tragic Errors

In 2008 and 2012, the U.S. Prevent- ive Services Task Force advised against PSA screening. A 2022 study published in JAMA found a significant increase in metastatic prostate cancers. Life Extension® predicted this would occur as PSA screenings decreased in response to this tragic error by the U.S. Preventive Services Task Force.

By William Faloon.

William Faloon

About 34,700 men in the U.S. perished from metastatic prostate cancer in 2022.¹

Many of the deaths can be attributed to the U.S. Preventive Services Task Force recommending against PSA screening in 2008 and 2012.²

As we long ago predicted, the penalty for avoiding PSA screening is an upsurge in metastatic prostate cancers.³

A landmark study published by the American Medical Association confirms the absurdity of advising men to not undergo PSA screening.

From 2004 through 2010, there were no statistically significant changes in the incidence rate of metastatic prostate cancer. Back then lots of men were having PSA blood tests to detect early-stage disease.²

Between 2010 and 2018 (after PSA screening declined) there was an approximate 41% increase in metastatic prostate cancer incidence.²

This study also found higher PSA levels at diagnosis, suggesting a higher risk of more advanced disease occurring after the U.S. Preventive Services Task Force advised against PSA screening.

The authors of this American Medical Association- published study predict that these data may translate into even higher future incidences of metastatic disease and deaths caused by delayed diagnoses.

This tragic error is an example of government- funded "committees" making sweeping policy recommendations that do not apply to most readers of Life Extension® Magazine.

Prostate cancer is the second leading cause of cancer death in men.¹

A low-cost blood test called PSA (prostate-specific antigen) is a screening tool to monitor prostate health.

This test can indicate when further diagnostics are necessary or prompt a man to initiate lifestyle changes that can reduce PSA levels.

Early detection is critical, because it helps to identify cancer in time for curative treatment to be initiated.⁴

What's interesting is how quickly PSA screening declined after misguided policy statements were issued by the U.S. Preventive Services Task Force.

Government-Funded Committees

The United States Preventive Services Task Force is a group funded by the federal government and private industry.⁵

In 2008, the United States Preventive Services Task Force recommended that men over age 75 not have their blood routinely screened for PSA.⁶

In 2012, the United States Preventive Services Task Force recommended against routine PSA screening for all men.⁷

These recommendations resulted in the media proclaiming that PSA screening should be halted.

My response was to write an article titled "Federal Death Panels," published in the May 2013 issue of Life Extension® Magazine.

Fewer PSA Screenings = More Metastatic Disease

In men 45 to 74 years old, there was a nonsignificant decline in the incidence rate of metastatic prostate cancer from 2004 to 2010 followed by an approximately 41% increase from 2010 to 2018. For men aged 75 years and older, there was a significant decline in incidence of metastatic prostate cancer from 2004 through 2011 followed by an even steeper 43% increase.²

Consequences of Reduced PSA Screening

The initial effect of the United States Preventive Services Task Force recommendations in 2008-2012 was a decline in prostate cancer diagnoses. This happened because as the number of PSA tests went down, so did new cases... at least in the beginning.

By the year 2016, however, 11,387 more American men were diagnosed with metastatic prostate cancer compared to 2008 levels, when PSA blood test prevalence was robust.¹⁰

In 2022, the American Medical Association published a huge study that found by 2018, about 12,300 more men were being diagnosed with metastatic prostate cancer each year... 41% of whom were aged 45-75 and 43% were above 75 years.²

Interestingly, in a multicenter randomized European trial, that did not follow the United States Preventive Services Task Force (USPSTF) recommendations for PSA screening, participants were followed up for 13 years. It was found that there was a 21% reduction in the risk of prostate cancer and a 27% reduction in the risk of prostate cancer mortality in PSA-screened men.¹¹

Here are some stark conclusions from the 2022 study by the American Medical Association:

"Our study of the recently released 2004 to 2018 SEER data set confirms a rising incidence rate of metastatic prostate cancer coinciding with the 2008 and 2012 USPSTF recommendations against PSA-based prostate cancer screening.

Although this increase was seen across all age groups, it was greater in men aged 75 years and older, as well as in non-Hispanic White men, and followed trends in PSA screening reduction." ²

Those who chose to follow the United States Preventive Services Task Force (USPSTF) guidelines of 2008-2012 are now at greater risk for advanced-stage disease.

Few metastatic prostate cancer patients will be cured.¹² Some are kept alive by grueling chemo-therapy, radiation, and hormone-ablation regimens.¹³

The needless suffering and deaths caused by this tragic error will likely go into the history books as an example of misinterpreting the use and value of a simple screening tool (PSA blood test) to detect and manage early-stage disease.

Update:

In December 2022, a widely publicized study found that 77% of prostate cancers in America are detected by PSA screening.⁹ This is a higher number of cancers caught in early stages than by mammography, colonoscopy, or PAP smears. Yet the United States Preventive Services Task Force still does not recommend universal PSA screening for all men over age 40.

Controlling PSA Levels

Detecting a rising PSA in early stages enables dietary, lifestyle, and other changes that can lower future PSA readings.¹⁸

PSA is more than a marker for prostate disease. Prostate cancer cells secrete abundant PSA that degrades healthy prostate tissues to make room for tumor expansion.¹⁹

We've published articles over the decades about how switching to a Mediterranean diet with emphasis on cutting back on red meat and dairy can reverse a rising PSA blood level.^20-25

Low-Cost Blood Tests

Record numbers of American men are battling metastatic prostate cancer, yet PSA screening is still underutilized.

Life Extension® long ago advocated that men over age 40 have an annual PSA test, along with measures of cardiovascular risk that can be neutralized if caught in early stages.

A PSA blood test costs $31.

A CBC/Chem/Lipids Panel that provides a broad spectrum of health indicators costs $35.

If you order by September 25, 2023, the price for the CBC/Chem/Lipids Panel + PSA blood tests is only $45 (Item # LC100081).

To order these discounted blood tests, call 1-800-208-3444 (24 hours/day) or visit: www.LifeExtension.com/PSA

History of PSA Testing

PSA was first identified in blood in 1979.¹⁴

Doctors began using PSA as a diagnostic tool when treating prostate cancer patients in 1987. The FDA approved PSA testing for this purpose in 1994.¹⁵

As advocacy groups like Life Extension urged men to utilize PSA as a screening tool, tens of millions of American men began adding PSA to their annual list of blood tests.

The number of lives spared by early detection remains a hotly debated topic. One reason for the controversy is that typical aging men develop multiple chronic conditions that often kill before clinically relevant prostate cancer develops.

The unhealthy status of average older men does not apply to those who take proactive steps to safeguard their health, as increasing numbers of informed consumers are doing.

Of interest, late in 2017, health authorities in Mexico published a legally binding national prostate cancer screening guideline stating that all Mexican men over age 45 should be screened using digital rectal examination and PSA. Men with a family history of prostate cancer should begin at age 40.¹⁶

In this instance, Mexico appears to be ahead of U.S. health officials in taking proactive steps to reduce the prostate cancer mortality of its citizens.

Before PSA testing was "approved"; by the FDA, enlightened Americans would travel to Mexico or other countries to have a PSA blood test performed. It was considered controversial in those early days.

For longer life,

William Faloon, Co-Founder, Life Extension®

References

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Desai MM, Cacciamani GE, Gill K, et al. Trends in Incidence of Metastatic Prostate Cancer in the US. JAMA Netw Open. 2022 Mar 1;5(3):e222246.
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Schroder FH, Hugosson J, Roobol MJ, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet. 2014 Dec 6;384(9959):2027-35.
Available at: https://www.cancer.org/cancer/prostate-cancer/detection- diagnosis-staging/survival-rates.html. Accessed January, 26, 2023.
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Wang MC, Valenzuela LA, Murphy GP, et al. Purification of a human pros- tate specific antigen. 1979. J Urol. 2002 Feb;167(2 Pt 2):960-4; discussion 4-5.
Available at: https://www.cancer.gov/types/prostate/psa-fact-sheet. Ac cessed January, 26, 2023.
Lajous M, Cooperberg MR, Rider J, et al. Prostate cancer screening in low- and middle-income countries: the Mexican case. Salud Publica Mex. 2019 Jul-Aug;61(4):542-4.
Karnes RJ, MacKintosh FR, Morrell CH, et al. Prostate-Specific Antigen Trends Predict the Probability of Prostate Cancer in a Very Large U.S. Veterans Affairs Cohort. Front Oncol. 2018;8:296.
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