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Study: PSA rise not good prostate cancer predictor


4 Star

Study: PSA rise not good prostate cancer predictor

Our Review Summary

It did a better job quantifying harms, but a weaker job in evaluating the evidence.  It also never addressed the option of not having PSA tests at all.

Neither story addressed costs – a big issue given the evidence about unnecessary biopsies.


Why This Matters

This story focused on the study results, evaluating the value of tracking rising PSA levels.  But it never dropped back to the big picture and never reminded men that NOT having a PSA test at all.  The competing HealthDay story did, giving it a small but significant edge in completeness.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

No discussion of costs – not of PSA testing nor of subsequent biopsies.  These are big cost issues that warranted at least a line.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?


The story states the 1 in 20 needing biopsy for total PSA vs. the 1 in 7 needing biopsy for PSA velocity. What the article doesn’t quantify is whether there would be fewer false positive findings if PSA velocity was ignored.

Does the story adequately explain/quantify the harms of the intervention?


Better job than its HealthDay competition in actually quantifying the impact on reducing unnecessary biopsies.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story didn’t do as good a a job as its HealthDay competition, which spelled out how men in the study were all from the placebo arm of a drug trial and which provided a bit more detail on the quality of the evidence.

Neither story indicated that study subjects were highly selected– normal prostate exam and PSA < 3 as entry criteria.  This is important information that may influence how generalizable the findings may be.

Does the story commit disease-mongering?


No disease mongering here.

Does the story use independent sources and identify conflicts of interest?


The story included quotes from two independent sources.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The HealthDay competition addressed in a much more explcit manner the option of not having the PSA test at all, when it reported: “Current American Cancer Society prostate screening cancer guidelines recommend that men make an informed decision with their doctor about whether to be tested for prostate cancer. “Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment,” according to the ACS.”

Does the story establish the availability of the treatment/test/product/procedure?


The story stated that most men over 50 get PSA blood tests.

Does the story establish the true novelty of the approach?


The story made it clear that the study was to examine the value in a common practice of doing a biopsy in men with a normal PSA level but in whom an increase in PSA has been detected.

Does the story appear to rely solely or largely on a news release?


Did not appear to rely on a sole news release.

Total Score: 7 of 10 Satisfactory


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