U.S. Task Force Says Prostate Cancer Screening Out, but Controversy Continues
The U.S. Preventive Services Task Force (USPSTF) on Monday said that it recommends against PSA-based screening for prostate cancer.
"Of 1,000 men who are screened, at most one man will avoid a prostate cancer death. Two to three will have blood clot, heart attack, stroke or even death from treatment of the prostate cancer. One in 3,000 men screened will die of surgical complications from the treatment,” LeFevre said to ABCNews.
The recommendation doesn’t mean that nobody can get a PSA screening. Men who want to get themselves screened can go through the procedure but only after their doctor has given them the details of the side-effects of the screening method.
"We have been told for decades to be terrified of cancer and that the only hope is early detection and treatment," The reality: You don't need to detect all cancers,” said Dr. Virginia Moyer of the Baylor College of Medicine, reports FoxNews.
Some experts say that the Task Force has overlooked critical details while forming the recommendation.
"There is no mention of the dramatic decline in the number of men with advanced prostate cancer. In 1990, 21 percent of men at diagnosis had metastatic prostate cancer to bone. Today it is 4 percent. This is clearly a dramatic effect of PSA testing,” said Dr. Patrick Walsh, a professor of urology at Johns Hopkins University, reports ABCNews.
Task Forces’ Monday recommendation has put down the on-going controversies regarding routine prostate screening since 2008 and in turn has created some new ones.
Men’s health Network and the Veterans Health Council have strongly opposed the USPSTF recommendation.
"A patient might presume they've had their PSA tested, then come back five or 10 years later with back pain only to learn they have prostate cancer that's spread to their spine, said Ian Thompson, chairman of urology at the University of Texas Health Science Center.
Informed decision making might be better than undergoing random tests.
“In the physician-patient relationship, men should be informed of the known risks and potential benefits and be encouraged to make a choice,” said Dr. Otis Brawley, chief medical and scientific officer of the American Cancer Society.
The most hard-hitting criticism is that the panel did not have any urologist in the panel.
"PSA screening is the only test we have. The great majority of doctors who deal with prostate cancer patients believe that the task force underestimated the benefits and overestimated the harms. Perhaps it is because none of the Task Force members were urologists,” said Dr. William Catalona, professor of urology at Northwestern University.
“We believe that elimination of reimbursement for PSA testing would take us back to an era when prostate cancer was often discovered at advanced and incurable stages,” write William Catalona and colleagues in an editorial published in Annals of Internal Medicine, “at this point, we suggest that physicians review the evidence, follow the continuing dialogue closely, and individualize prostate cancer screening decisions on the basis of informed patient preferences.”
The Obama Administration said that Medicare will continue to pay for PSA screening.