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Ending routine PSA testing for prostate cancer

Do routine screenings cause more harm than good?
Do routine screenings cause more harm than good?
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This week, the U.S. Preventive Services Task Force publicly called for putting an end to routine PSA tests for prostate cancer.

The group’s reasoning is that these tests often do more harm than good. For instance, while a test might result in revealing that someone has a tumor, the tumor might not be exactly life-threatening. Treatment in these situations, including biopsies and surgery, can potentially leave a patient impotent, incontinent or even worse—dead. That seems quite a price to pay for an affliction that wouldn’t necessarily put one’s life in danger if left alone. It’s for this very reason that the Task Force has already been advising for men over 75 not to get prostate cancer screenings at all.

Opponents of this plan, specifically the American Urological Association, are intensely upset with the Task Force’s proclamation. They claim that routine PSA tests prevent up to 40% of prostate cancers in men by catching the disease early, when it’s still curable.

But the argument once again becomes about the nature of cancer itself: do all cancers need to be detected early and cured? Could unnecessary treatment cause more harm than good? How can you tell when treatment is definitely necessary for prostate cancer and when it’s better to let sleeping dogs lie? What have your experiences been with prostate cancer screenings? Do you feel they are a beneficial tool? Or just another excuse to run up more healthcare costs?


Michael Lefever, M.D., Co-vice chair of the U.S. Preventive Services Task Force that wrote the new guidelines for PSA testing. Dr. Lefever is also the Future of Family Medicine Professor and Vice Chair of the Department of Family and Community Medicine and Chief Medical Information Officer for MU Health Care at the University of Missouri

Dr. Jeffrey Kaufman, Urologist, Western Medical Center in Santa Ana; Board member, American Urological Association; Past President, California Urological Association; Professor of Clinical Urology, University of California, Irvine

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