Prostate test should be between ‘man and his doctor’?
The U.S. Preventive Services Task Force, the same group that recommended doctors scale back on mammograms for women, is thinking of recommending against use of the prostate-specific antigen or PSA test.
The task force, an independent panel appointed by the federal government, plans to give a common blood test known as the PSA test a rating of “D,” suggesting there is moderate or high certainty that the test has no net benefit or that the harms outweigh the benefits. The draft report was obtained by The Cancer Letter newsletter and is scheduled to be published Tuesday.
Current recommendations say there is insufficient evidence to support the use of the test.
“[The] decision of no confidence on the PSA test by the U.S. government condemns tens of thousands of men to die this year and every year going forward if families are to believe the out-of-date evidence presented by the USPSTF,” said Skip Lockwood, chief executive of ZERO, a group devoted to ending prostate cancer.
“A decision on how best to test and treat for prostate cancer must be made between a man and his doctor. This decision is coming from a panel that doesn’t even include a urologist or medical oncologist.”
Dr. Scott Eggener, an expert in prostate cancer from the University of Chicago, said the new recommendations, if adopted, would discourage men from getting prostate cancer screening.
Eggener said the move “is a classic example of ‘throwing the baby out with the bath water.’ A more sensible approach is to use all of our currently available tools to intelligently determine which patients are most likely to benefit from screening and treatment.”
The prostate-specific antigen or PSA test measures levels of a protein produced by the prostate gland to gauge a man’s risk of prostate cancer, but the test has a high rate of false positives.
“The concern is the test could elevated with benign problems like inflammation or enlarged prostate and once you have the elevated test it leads you to a biopsy, unnecessary treatment,” NBC’s Dr. Nancy Snyderman told “Nightly News with Brian Williams” Thursday. “As we talk about economics, it comes back to not hurting the patient, not spending undue money.”
Many studies have suggested that PSA screening does more harm than good because it can identify slow-growing cancers that may never have posed any health threat.
And once men hear they have a risk of prostate cancer, they often opt for treatment, which can cause impotence and incontinence.
The problem is that there is no accurate way at the moment to tell which tumors are deadly, and which are harmless.
And prostate cancer remains deadly. It is the second leading cause of cancer death in the United States behind lung cancer.
Lockwood said recent studies, including one from Sweden, have suggested the PSA test saves lives.
According to the American Cancer Society, around one man in six will be diagnosed with prostate cancer during his lifetime. More than 2 million men in the United States who have been diagnosed with prostate cancer at some point are alive today.
Dr. Virginia Moyer of Baylor College of Medicine who chairs the task force, told Reuters the task force has an evidence report coming out in the Annals of Internal Medicine on Tuesday.
And she confirmed that an evidence recommendation statement will be released, which is a draft statement that will be posted for a month-long public comment period.
A spokeswoman for the journal did not respond to requests for comment.
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