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hlthe2b

(110,693 posts)
4. While I am not necessarily in agreement, mind you:
Mon May 19, 2025, 09:57 AM
May 19
The United States Preventive Services Task Force (USPSTF) guidelines advising against PSA testing for men aged 70 and older were revised in May 2018. Prior to that, the USPSTF had previously recommended against PSA testing for all men. The 2018 update specifically addressed men in the 55-69 age range, allowing for individual decision-making with their doctor after discussing the potential benefits and harms of the test, while continuing to discourage PSA testing for those 70 and older.


I am not a urologist, but I do understand the issues with this highly sensitive, but poorly specific test. What that means is that men with benign prostatic hyperplasia (BPH), a very common non-cancer enlargement that comes with age can also trigger an increase in PSA, so a digital exam is recommended. That said, the USPSTF also looked at the risk-benefits of aggressive treatment, whether surgery, radiation, or chemotherapy in men over the age of 70 with likely concomitant medical risk factors (e.g., heart disease, hypertension, etc.) and determined that the treatments and diagnostics from false positive PSA readings or even indicated treatments might pose more risk than benefit in this older age group. That is the thinking (along with some unnecessary cost issues, because MRI is the indicated test to sort it out at considerable expense).

Does any of the above really apply to a current or recent President whose medical care is basically unlimited? Probably not, but there are issues that Biden's physicians would have taken into account--whatever they might be.

Recommendations

2 members have recommended this reply (displayed in chronological order):

Simple really Johnny2X2X May 19 #1
It is faulty reasoning which is using outdated recommendations. PSA is simply a data point, and if it JohnSJ May 19 #11
A high PSA without prostate cancer is not a false positive for cancer NoRethugFriends May 19 #12
What is your reasoning? Semantics? Bernardo de La Paz May 19 #15
My thinking is that I clearly didn't wind up finishing the post. My bad. I corrected it. NoRethugFriends May 19 #19
the husband of a dear friend died of dementia back last July. I was shocked. I had no idea one could die of dementia but CTyankee May 19 #23
In Alzheimer's, the brain deteriorates to the point it cannot handle basic bodily functions, Midnight Writer May 19 #24
I think you are correct Bluetus May 19 #31
Because the common "wisdom" is that if you're 70 or older, the relief is a hard thing on an older fellow ... marble falls May 19 #2
No idea. J_William_Ryan May 19 #3
BPH can effect PSA values, but based on prostate size, density, PSA velocity, etc. They can reasonably JohnSJ May 19 #14
I completely agree about the annual PSA Bluetus May 19 #32
While I am not necessarily in agreement, mind you: hlthe2b May 19 #4
Those recommendations in regard to PSAs are outdated. PSAs are simply a data point which indicates JohnSJ May 19 #17
These are the official recommendations. While I clearly stated I as a professional do not necessarily agree hlthe2b May 19 #20
Yes, I agree it does need to be individualized, but the fact that the decision by too many physicians JohnSJ May 19 #29
Thanks for this very helpful post karynnj May 19 #25
Yes. He does. It was included in an earlier medical report released publicly. hlthe2b May 19 #27
I am not over 70 yet but I demand a PSA test at every yearly exam. You can choose to not treat if it is non-aggressive. dutch777 May 19 #5
I'm a truck driver, so naturally I go for a physical every year at the VA including a PSA test, MarineCombatEngineer May 19 #6
My last PSA was 7.9. Supposedly, normal is 4.0 I am told. My doctor says the 7.9 is my normal. OLDMDDEM May 19 #7
Hubby was just told his normal seems to be 6.4 woodsprite May 19 #26
Everyone is different. Our son is worried because his is over the 4.0 norm. My norm being in the OLDMDDEM May 19 #28
Over treatment is no joke Luvcatz14 May 19 #8
I read that they say do the test between 50 and 69. n/t malaise May 19 #9
Hmmmm Littlered May 19 #10
Here's the American Cancer Society recommendation surfered May 19 #13
Thanks malaise May 19 #21
Hope you don't have a problem 🙏 surfered May 19 #33
No problem malaise May 19 #39
My experience: surfered May 19 #16
The PSA test does not reveal anything really. dugog55 May 19 #18
I'm missing... Mike Nelson May 19 #22
Is this the test obnoxiousdrunk May 19 #30
See my reply below. Aristus May 19 #35
I order a PSA for every fifty+ year-old male coming in for an annual physical exam. Aristus May 19 #34
Don't think it's providers but HCIs that don't mind if people suffer uponit7771 May 19 #36
Health insurance companies for sure, at least. Aristus May 19 #37
There no doubt needs to be public options for HC like USPS which Americans like cause they do a decent job when uponit7771 May 19 #40
It depends on your doctors Meowmee May 19 #38
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