Blog | Wednesday, March 31, 2010

No End in Sight for Prostate Cancer Screening


This post by Kevin Pho, ACP Member, aka KevinMD, appeared at Better Health.


Is the tide finally turning on PSA screening for prostate cancer? There's no definitive data that PSA screening saves lives from prostate cancer, and it indeed can lead to further invasive tests that can cause men significant discomfort. Medical societies are divided on the issue. Primary care groups like the U.S. Preventive Services Task Force recommend against it for older men, while the American Urological Association continues to recommend screening.

Prostate cancer, adenocarcinoma, from MKSAP, (c) American College of PhysiciansIn a strongly worded op-ed in the New York Times, Richard Ablin, also known as the founder of the PSA test, bemoans how our healthcare system has twisted its use. "The test's popularity has led to a hugely expensive public health disaster," he writes.

Who's responsible? According to Dr. Ablin, it's the drug companies: "So why is it still used? Because drug companies continue peddling the tests and advocacy groups push 'prostate cancer awareness' by encouraging men to get screened."

He's leaving out other culprits. If the public is to be convinced of the PSA test's fallibility, public figures need to get off the bandwagon. That includes prominent prostate cancer survivors like Senator John Kerry, who implores the public to be screened, without explaining the possible ramifications.

And what of the legal consequences? Dr. Daniel Merenstein dutifully explained the risks of PSA screening to a patient, but got sued for his efforts and was forced to settle. Maybe he was ahead of his time.

Until we can better educate the public on PSA's risks, and protect doctors from malpractice, PSA screening will continued to be rampantly ordered.

This post originally appeared on Better Health, a network of popular health bloggers brought together by Val Jones, MD. Better Health's mission is to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the provider point of view on health care reform, science, research and patient care.