Monday, May 21, 2012

Most Men Should Skip PSA Test According to USPSTF...

  The United States Preventative Services Task Force (USPSTF) has released a report in the Annals of Internal Medicine that suggests most men should seriously consider not undergoing a PSA test to check for Prostate Cancer. The risks may outweigh the benefit for the vast majority of men, according to the group's Chairperson, Dr. Virginia Moyer. "It’s important for doctors and patients to understand that our current approach to screening for prostate cancer does not serve men well,” said Dr.  Moyer.  "There is a critical need for a better test—one that leads to early detection of cancers that threaten men’s health, but minimizes unnecessary, risky tests and treatments that do not lead to longer or more healthful lives.”

The study further says that the test, at its most effective, may help just a single male out of a thousand avoid death from Prostate cancer. Usually, cancer of the prostate is very slow growing and occurs in older men, who typically die from something else.

There are also side-effects that have been found to occur in men who seek treatment after learning they have tested positive in the PSA test, including a small percent of men who experienced blood clots, heart issues and to a greater degree (40/1000)  are rendered impotent or incontinent.

The government based group is not suggesting that the test be banned whatsoever. Rather, they simply recommend that most men not even take the test, since any that do test positive will usually seek treatment, which is more problematic than any real issues the actual prostate cancer produces.  

In the end, they clearly indicate this is a personal choice for a patient, who should discuss his concerns with his doctors. 

"You should know what the science says about PSA screening: There is a small potential benefit and there are significant potential harms. But you should also think about your personal beliefs and preferences for health care. Weigh the potential benefits and harms of PSA screening and decide what is most important to you. If the possibility, however small, of avoiding death from prostate cancer is more important to you than the risk of unnecessary harms, then screening may be the right decision."

You can read more about the current situation with Prostate Cancer treatment here and an opposing  viewpoint here.   

It is interesting to me that there are no urologists or cancer specialists on the USPSTF.  Another good point made in the opposing viewpoint article points to a concern for a passive treatment approach with younger men (55-69) for whom the slow growing cancer may have had an early enough start to indeed be of profound concern. 

Its interesting every time the Task Force makes a recommendation. We ought not panic and be afraid that the Government is trying to kill us but rather this board of medical experts is bringing their years of knowledge and experience to bear on various medical screenings that may simply not provide a benefit to all who undergo them.  Remember the fuss about the Mammograms a few years ago? 


Don't Bother With PSA Test, Expert Board Says - Maggie Fox -

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