The US Preventive Task Force Recommends Against PSA Screening

Harms of treatment - Prostate Cancer

Debate over PSA screening continues in the wake of inconclusive evidence regarding its benefits.

According to the US Preventive Task Force, healthy men should no longer be mandated to take a PSA blood test since:

It does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence, and incontinence.

The recommendation comes after analysis of the results of 5 clinical trials and could guide the course of future prostate care for men in the US. The chairwoman of the task force, Dr. Virginia Moyer, professor of pediatrics, Baylor College of Medicine says that:

This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. Unfortunately, the evidence now shows that this test does not save men’s lives.

The task force is up against many groups of patients, scientists, physicians, drug makers with this recommendation. Baseball star Joe Torre, former New York City Mayor Rudolph W. Giuliani, financier Michael Milken are among those who advocate the benefits of the PSA screening test and they are among the thousands who believe that the PSA saved their lives.

The PSA Blood Test and Some Statistics

The PSA test is a routine test prescribed for men 50 years of age and older. The test measure the amount of prostate specific antigen that is given out by prostate cells and increased levels is indicative of presence of tumor in the prostate.

Prostate cancer is a slow growing cancer and majority of men who have it never suffer ill effects. The increased use of PSA screening has led to the unearthing of the consequences of biopsies and treatments.

The period between 1986 to 2005 saw:

  • One million men receiving prostate removal surgery, radiation therapy, or both after being detected with prostate cancer via routine PSA screening.
  • Of these, 5000 patients died following surgery.
  • 10,000 to 70,000 suffered from serious complications.
  • Half the people had persistence blood in semen.
  • 200,000 to 300,000 suffered impotence and incontinence.

These appalling discoveries led to the test being described as ‘a public health disaster’ by none other than the developer of the test, Dr. Richard J. Ablin himself.

Recommendations Drawn from Trials Conducted to Asses PSA Testing Value

Among the trials conducted, two of the largest were in the United States and Europe. Both of them demonstrated that benefits are minimal and almost non-existent after a period of 10 years. The recommendations of the task force are for only healthy men and they have not considered men with complaints and symptoms or men who have been treated for the condition before.

The debate whether the PSA screening can save lives and whether at all, it is required continues. In the wake of the Obama administration already at the receiving end for rationing of health care services, the task force’s recommendations would most likely be greeted with apprehension and anxiety when it opens for public comment the coming week.

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