Prostate cancer screening report sparks debate among doctors, survivors

Dylan Stableford
The Lookout

A controversial new report that recommends against routine prostate screenings has sparked a wide debate among doctors, cancer survivors and patients.

The U.S. Preventive Services Task Force issued its final report on Monday, recommending against prostate-specific antigen (PSA) screening for prostate cancer for men of any age. The reason? Very few men actually need treatment to survive and the side effects from prostate cancer treatment do more harm than good, the task force said.

From the report:

Prostate cancer is the most commonly diagnosed non-skin cancer in men in the United States, with a lifetime risk for diagnosis currently estimated at 15.9%. Most cases of prostate cancer have a good prognosis even without treatment, but some cases are aggressive; the lifetime risk for dying of prostate cancer is 2.8%. Prostate cancer is rare before age 50 years, and very few men die of prostate cancer before age 60 years. Seventy percent of deaths due to prostate cancer occur after age 75 years.

It goes on to say:

There is adequate evidence that the benefit of PSA screening and early treatment ranges from 0 to 1 prostate cancer deaths avoided per 1000 men screened.

"Many men are harmed by prostate cancer screening," Michael LeFevre, co-chairman of the task force and professor at the University of Missouri School of Medicine, said. "Very few will benefit."

Dr. Virginia Moyer, another member of the task force, told CNN that just one out of every 1,000 men screened for prostate cancer needs the exam, with side effects such as incontinence, impotence, stroke and death related to "overdiagnosis" of prostate cancer treatment far outweighing the benefits.

"Your primary care physician shouldn't routinely offer the exam," Moyer said.

Prostate cancer is the second deadliest cancer among men, according to the American Cancer Society. However, CNN noted, 91 percent of all men with prostate cancer will live for 15 years beyond the diagnosis, which is considered a high rate of survival.

The American Urological Association immediately fired back. "We at the AUA still recommend the PSA, with its imperfections," Dr. Chris Amling told the network. "It's the wrong thing to deny a man if he wants to have this test. There is no other screening test for prostate cancer. It's clear that the only way to cure prostate is to detect it early."

And many prostate cancer survivors disputed the task force recommendation to skip the PSA exam.

"With my family history, the PSA was essential in monitoring my cancer," Bruce Stambaugh, who says his father died of prostate cancer and he and his brother were treated for it, wrote on the Houston Chronicle's blog. "Without the regular PSA tests ... I could only guess if I had cancer or not."

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