Many men aren't benefiting from a simple blood test for prostate cancer, because their urologists aren't using the test to eliminate unnecessary and expensive prostate biopsies.

That's the conclusion based on results from a survey of American urologists attending the American Urological Association's annual conference, held last week in Anaheim, Calif. The survey was conducted by the Men's Health Network (MHN), which released the results today during National Men's Health Week.

"The survey suggests many doctors are not yet taking advantage of the risk-assessment information that the free-PSA test provides about how likely prostatic biopsies are to show cancers in individual cases," said a leading authority on prostate cancer testing, William J. Catalona, M.D., of the Washington University School of Medicine. "That means patients may not have all the information they need to make an informed decision about whether or not to have a biopsy."

Prostate biopsies routinely cost more than $1,000, involve discomfort and anxiety, and can cause complications such as infection, fever, urinary retention and rectal bleeding.

"Doctors and patients should be aware that in many cases, there is a readily available alternative to prostate biopsy," said Tracie Snitker, an MHN spokesperson.

The free-PSA test is FDA-approved and clinically proven to help detect prostate cancer with great accuracy. Leading cancer researchers have concluded the test can eliminate 20 percent of unnecessary biopsies, among men who have moderately elevated levels of total PSA and a negative digital rectal exam (DRE).

But the MHN survey found most urologists do not perform a simple free-PSA blood test before referring these men for biopsy.

American Cancer Society guidelines clearly recognize the test's role in detecting cancer. The guidelines say restricting biopsy "to men with less than 20 percent free-PSA improves testing accuracy," and that proper use of the test "may result in a lower biopsy rate compared with older strategies."

Nearly 90 percent of urologists reported that when they recommend a prostate biopsy, patients at least occasionally ask if there is an alternative.

Even though many urologists do not perform a free-PSA blood test before referring men with moderately elevated PSA levels for biopsy, most urologists do nonetheless employ the test to assess these patients' condition.

The large majority of responding urologists recommends the test for men who have a negative DRE and moderately elevated PSA levels, and especially for men with moderately elevated PSA, a negative DRE and a negative biopsy.

"PSA is the best cancer tumor marker in all of medicine, but there has been understandable pressure to improve its accuracy," said Dr. Catalona. "Free-PSA is the best available way to improve the accuracy of total PSA tests."

Dr. Catalona authored a major study on the free-PSA test, establishing the test's role and effectiveness in detecting cancer while eliminating unnecessary biopsies.

A Men's Health Network board member, David Gremillion, M.D., of the University of North Carolina School of Medicine, praised PSA and free-PSA testing as providing "an opportunity for men that can rival the benefits of regular preventive care that women receive when they go for their annual Pap smears and screening mammograms."

The survey of U.S. urologists was performed by representatives of the Men's Health Network from June 3-6, 2001. Beckman Coulter, which manufactures the Hybritech free PSA test, provided an educational grant to conduct the survey.

National Men's Health Week is celebrated each year as the week leading up to and including Father's Day (June 11-17 this year). For more information, access www.menshealthweek.org.