Update on Government Panel Recommendation to Discontinue PSA Screening.

As discussed in this website blog posted on October 15th, a government medical panel, the United States Preventive Services Task Force, recently recommended that routine PSA testing in healthy men under the age of 75 be discontinued unless they have symptoms that are highly suspicious for prostate cancer. The panel claimed that such routine screening did not result in the overall saving of lives but instead led to an increase of  potentially harmful side effects. This controversial recommendation has produced considerable comment. The Johns Hopkins Health Alerts  posted an excellent review of this issue in their October 26th edition. I recommend reading the Johns Hopkins review of the current situation and the government panel’s rationale for their recommendation. Johns Hopkins’ advice was as follows. “Many leading cancer and patient groups and doctors agree that there is harm with PSA screening and the treatment that follows diagnosis. But a more targeted screening approach focusing on those at greatest risk of developing prostate cancer and active surveillance for those who don’t need immediate treatment, could shift the balance of benefit and harm toward benefit. PSA screening is the best test available for the detection of cancer cells in the prostate. Rather than discontinuing use of the only test available to detect the disease early and treat it successfully, efforts should focus on reducing harm.”

In addition, the November 1st edition of the ZeroHour Newsletter from the Project to End Prostate Cancer, cited an article published on October 28th in U.S. News and World Report, disclosing the results of a survey of urologists and internal medicine specialists’ responses to the government recommendation. “Virtually all responding urologists and more than 60 percent of internal-medicine specialists rejected the recent proposal by a high-level government advisory committee to end routine PSA testing.” About 95 percent of the responding urologists felt that doctors should continue to advise men starting at age 50, when testing typically begins, to have PSA screenings as part of a routine physical exam, contrary to the task force’s recommendation. There was however agreement that too many patients are encouraged to seek radical prostatectomy or radiation treatments and too few are informed about “watchful waiting”, in which periodic PSA tests, frequent physical exams, and biopsies are used to track a tumor’s growth and decide when, if ever, to pursue aggressive treatment.

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