Back in 2009 in NEJM a European group reported the results of a study that alleges that PSA testing has no value after certain ages. Now the group adds additional data but claims only marginal improvement. It still delimits testing to less than 75.
However as I noted then and now again the test protocol was:
The screening interval at six of the seven centers was 4 years (accounting for 87% of the subjects); Sweden used a 2-year interval. In Belgium, the interval between the first and second rounds of screening was 7 years because of an interruption in funding.
As I had noted, I have seen patients got from 4 to 40, and 40 to dead in 4 years. Testing annually, along with %Free is essential just for monitoring. Measuring rates of increase are sine qua non. Change is the critical factor in any diagnosis.
PSA value can vary from one test method to another. From time of day. From state of exercise such as cycling. And other factors. The more frequent the measures the more these exogenous factors can be averaged out. Yet if we have 4 year intervals in my opinion and my experience the results are useless.
These studies were used to justify reducing PSA monitoring and eliminating it in the over 75 group. PCa is a horrible disease if not caught early. More frequent PSAs under common conditions using the same method of valuation is essential.
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