Dr. Louise C. Walter of San Francisco Veterans Affairs Medical Center and colleagues sought to quantify five-year outcomes following an abnormal PSA screening result of 4 or more, in older men age 65 and older.
A total of 295,645 men age 65 or older underwent PSA screening in the Veterans Affairs healthcare system in 2003. They were followed up for five years.
In total, 25,208 men, or 8.5 percent, had an index PSA level exceeding 4. During the five-year follow-up period, 8,313 men, or 33 percent, underwent at least one prostate biopsy and 62.8 percent who underwent prostate biopsy were diagnosed as having prostate cancer, of whom 82 percent were treated for prostate cancer.
Performance of prostate biopsy decreased with advancing age and worsening health, whereas the percentage treated for biopsy-detected cancer exceeded 75 percent even among men age 85 or older, those with a Charlson-Deyo Comorbidity Index of 3 or higher, and those having low-risk cancer.
Among men with biopsy-detected cancer, the risk of death from non-prostate cancer causes increased with advancing age and worsening health, the study said.
The findings were published in the journal Internal Medicine.