Prostate cancer screenings in men 70 and older

THE QUESTION: Are doctors doing unnecessary screening for prostate cancer in men 70 and older?

THE CONTEXT: For men with a life expectancy of less than 10 years, the risks associated with screening for prostate cancer outweigh the benefits. But some reports have suggested that many sick, elderly men are being screened.

THE STUDY: Researchers studied the records of nearly 600,000 men age 70 and older who were treated by the Department of Veterans Affairs (VA) in 2002 and 2003. They analyzed their health status and whether or not they were given prostate-specific antigen screening, also known as PSA screening.

THE RESULTS: In all, 56 percent of the men received PSA screening. The percentage of men who were screened declined with age. But within each age group, men who had lower life-expectancy - and therefore stood to benefit less from screening - were screened roughly as often as healthier men with a higher life expectancy.

Among men 85 and older, fewer than 10 percent have a life expectancy of 10 years or more. Nevertheless, roughly one-third were screened -- a figure that held constant for the healthiest and sickest subgroups.

The authors concluded that screening rates among men with low life expectancies should be "much lower than the current practice.''

The abstract of the study, which was published in the Journal of the American Medical Association, is available online at jama.ama-assn.org.