A federal task force has concluded that due to so much unnecessary anxiety, surgery and complications, the blood test, or prostate-specific antigen test (PSA), millions of men undergo each year to check for prostate cancer should be stopped for older men. They are still trying to determine whether the screening is worthwhile for younger men. The panel that sets government policy on preventive medicine has stated evidence that the test reduces that cancer’s death toll is too uncertain to support routine use for men at any age. Ned Calonge, the chairman of the sixteen member U.S. Preventive Services Task Force, said the benefit of the screening is uncertain and if there is a benefit, it is probably very small, while the risks are large and dramatic. The study specifically concluded that the risk of being harmed far outweighed the benefits of the screening starting at the age of 75.
This recommendation comes at a time when doctors are questioning many tests, procedures and drugs due to overuse unnecessarily driving up the cost of health-care costs and exposing patients to the risks of the unneeded treatments. Several leading medical groups, such as the American Cancer Society and National Cancer Institute, have praised these findings while others are criticizing the findings, arguing routine screening is necessary. They also note prostate cancer death rates in countries that have instituted widespread prostate cancer screening have plummeted. Each year, more than 218,000 men in the United States are diagnosed with prostate cancer. About 28,000 die of the cancer making it the most common cancer and second-leading cancer killer among men. However, prostate cancer usually grows so slowly, men die of something else without even knowing they had the disease.
The PSA test, which measures the protein in blood produced by prostate tissue, has drastically increased the number of patients able to detect their prostate cancer at its early stages. It remains unclear, however, whether or not this detection method decreases the death rate from the disease. Many times, the test gives a false detection of cancer since it is unclear what PSA levels signal the presence of cancer. This leads to unnecessary stress and surgical biopsies to make a definitive diagnosis, which can sometimes be painful and cause serious complications. Even when men do learn they have prostate cancer, doctors are uncertain what to do to treat it. Many are monitored to see whether the tumors are growing, while others undergo hormone treatment, radiation and surgery, which can leave them with complications such as impotency.
A recent Swedish review found men sixty-five or older who were treated for their prostate cancer were not more likely to survive than those who were not. Two large studies in the United States and Europe are currently underway to determine whether screening reduces mortality.