Task force: PSA tests do more harm than good

  • Posted by a hidden member.
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    May 22, 2012 9:11 AM GMT
    This is literally incredible. To highlight: "The task force says the PSA exam and additional treatments that may follow, like radiation and surgery, result in far more harm than benefit. [...] Instead, most will have to deal with side effects from treatment that can range from incontinence and impotence, to stroke and death."

    So basically, this US taskforce suggests that it's better not to know and suffer the consequences? Is there any way this can be framed as not being a cost saving move either under Obamacare or for insurers?

    Will you stop getting PSA exams?

    http://thechart.blogs.cnn.com/2012/05/21/task-force-psa-tests-do-more-harm-than-good/?hpt=he_c1

    The United States Preventive Services Task Force issued their final recommendation on the PSA prostate cancer-screening test Monday, recommending against routine PSA exams for men of any age. The task force says the PSA exam and additional treatments that may follow, like radiation and surgery, result in far more harm than benefit.

    Dr. Virginia Moyer, who sits on the task force, cited that only one out of every 1,000 men who are screened would actually benefit from the exam. Instead, most will have to deal with side effects from treatment that can range from incontinence and impotence, to stroke and death.

    “Your primary care physician shouldn’t routinely offer the exam," said Moyer. "But if a patient brings it up, that doctor has a responsibility to inform them of the potential harms and risk."

    However, the American Urological Association is not changing its stance on the PSA test. “We at the AUA still recommend the PSA, with its imperfections," said Dr. Chris Amling. "It’s the wrong thing to deny a man if he wants to have this test."

    The PSA test measures the amount of prostate-specific antigens in the blood. While the screening detects the presence of prostate cancer, it cannot make the distinction between aggressive, fast moving cancers, and the more common slow growing ones.

    “There is no other screening test for prostate cancer. It’s clear that the only way to cure prostate is to detect it early," Amling emphasized.

    According to the American Cancer Society, prostate cancer is the second deadliest cancer among men, and occurs most often in African-American. But survival rates also are very high. The American Cancer Society finds that 91% of all men with prostate cancer will live for 15 years beyond diagnosis. According to the National Cancer Institute, 70% of prostate cancer deaths occur after age 75.

    Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society supports the recommendation of the task force. “People need to realize that science hasn’t given us the answer," said Brawley. "In the past, when we don’t have a scientific answer, and we’ve guessed, we’ve hurt a lot of people."
  • Posted by a hidden member.
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    May 22, 2012 6:53 PM GMT
    This has nothing to do with PPACA ('Obamacare', as you call it). The USPTF is not affiliated with any political party. They are an independent group of experts who review the latest high-quality studies to make evidence-based screening recommendations. They don't make laws or ban things. PSA tests are still available.

    This recommendation was made because several large trials have failed to shown any consistent mortality benefit from PSA screening over large populations. Treatment puts people at risk for side effects--erectile dysfunction, retrograde ejaculation, incontinence, chronic diarrhea--which were judged to outweigh any small benefit.

    Following this recommendation probably would save costs, and I don't know who would object to saving costs on US healthcare. I think there are legitimate criticisms made of the recommendation, but criticize the science, not the politics.
  • musclmed

    Posts: 3284

    May 23, 2012 3:58 AM GMT
    Fahrenheit saidThis has nothing to do with PPACA ('Obamacare', as you call it). The USPTF is not affiliated with any political party. They are an independent group of experts who review the latest high-quality studies to make evidence-based screening recommendations. They don't make laws or ban things. PSA tests are still available.

    This recommendation was made because several large trials have failed to shown any consistent mortality benefit from PSA screening over large populations. Treatment puts people at risk for side effects--erectile dysfunction, retrograde ejaculation, incontinence, chronic diarrhea--which were judged to outweigh any small benefit.

    Following this recommendation probably would save costs, and I don't know who would object to saving costs on US healthcare. I think there are legitimate criticisms made of the recommendation, but criticize the science, not the politics.


    when you graduate and start working you will understand the power of these types of groups.

    Its a arm of the HHS. Although Independent " wink wink " you do not get on that board unless you play patty cake with politics.
  • vintovka

    Posts: 588

    May 23, 2012 4:13 AM GMT
    musclmed said
    Fahrenheit saidThis has nothing to do with PPACA ('Obamacare', as you call it). The USPTF is not affiliated with any political party. They are an independent group of experts who review the latest high-quality studies to make evidence-based screening recommendations. They don't make laws or ban things. PSA tests are still available.

    This recommendation was made because several large trials have failed to shown any consistent mortality benefit from PSA screening over large populations. Treatment puts people at risk for side effects--erectile dysfunction, retrograde ejaculation, incontinence, chronic diarrhea--which were judged to outweigh any small benefit.

    Following this recommendation probably would save costs, and I don't know who would object to saving costs on US healthcare. I think there are legitimate criticisms made of the recommendation, but criticize the science, not the politics.


    when you graduate and start working you will understand the power of these types of groups.

    Its a arm of the HHS. Although Independent " wink wink " you do not get on that board unless you play patty cake with politics.


    I think Fahrenheit's point was that this is a fundamentally scientific argument, irrespective of the politics going on in the wings. If we don't adjust our use of screening tests to account for false positives, then we fundamentally misunderstand statistics, not politics. More care does not inevitably indicate better care.