Unique Risk Tool Combined with PSA Test at Intermountain Helps Men Make Informed Decisions

Jess Gomez or Tiffany Harston

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MURRAY – Experts at the Intermountain Medical Center Urological Institute say men should continue having the PSA prostate cancer-screening test, even though a U.S. task force is discouraging physicians from using the test among healthy men.
“Eliminating this blood test would be a mistake for our patients,” says Jay Bishoff, MD, director of the Intermountain Medical Center Urological Institute.  “While we agree the PSA is not a perfect test, our experience, supported by data, shows the test has reduced prostate cancer-specific deaths by 44 percent. The PSA can, and does, save lives.”
Last week, the United States Preventative Services Task Force published their final recommendation for prostate cancer screening. The new guidelines, which are causing debate and confusion from physicians and patients, recommend against routine PSA screening in healthy men, regardless of age.

This has left many men confused and wondering what to do.
Used alone, Dr. Bishoff says the test’s value can be debatable. But when paired with other tools, a PSA test can be very useful in identifying a man’s risk of cancer. Intermountain Medical Center Urological Institute physicians use a special risk calculator that takes into account other factors like BMI, race, family and genetic history and medical history in addition to a PSA score.
Intermountain Healthcare is the only integrated medical system in the nation that uses this tool to enhance the PSA score.
This unique risk calculator gives Intermountain urologists a more accurate picture of the likelihood of prostate cancer. It decreases unnecessary biopsies and gives patients key information so they can be an informed part of the decision-making process.
“At one hospital, a patient may have a PSA of 3.8 and his doctor may say he’s fine,” Dr. Bishoff says. “But at Intermountain physicians put that score into a calculator along with information about race, age, and medical history to come up with a much more precise indication of risk. So, for example, if this patient is African-American, has an abnormal rectal exam and is taking finasteride, a drug used to prevent prostate cancer, then his cancer risk is about 53 percent. That’s critical information — and we wouldn’t have it without the PSA test. It is very likely that this patient will choose to have a biopsy.”
Dr. Bishoff and his colleagues worked with the Intermountain Lab to incorporate the risk calculator into PSA test results so patients are given results of both on the same report.
Prostate cancer is the second leading cause of cancer deaths in men. There are 250,000 new cases and 30,000 deaths each year nationwide. In Utah, one in six men will have prostate cancer in their lifetime.
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