US Task Force Now Against Prostate Cancer PSA Test for Every Age Group

May 22, 2012 by  
Filed under Prostate Cancer News

The U.S  Preventive Task Force, which is made up of 16 non federal, primary-care providers that review and make recommendations for preventive health services in the country has issued its final verdict on the controversial Prostate Specific Antigen(PSA) test for men with prostate cancer.

The decision of this Task Force was made known on Monday, 20th May, 2012 and published in the Annals of Internal Medicine Online.

The Task Force in its previous recommendation discourages screening for men above 75 years but now, it discourages PSA screening for men of any age. What are its reasons? Simple, there are now convincing benefits.

Moreover, it noted that men are more at risk of going for prostate cancer treatment because of the huge side effects like impotence, incontinence etc. Here is an online extract about this latest recommendation from the US Preventive Task Force:

Men shouldn’t be screened for prostate cancer with a common blood test, a widely followed federal advisory panel recommended on Monday. But the report isn’t likely to quell a dispute about whether the test’s risks outweigh its potential benefits.

Men shouldn’t be screened for prostate cancer with a common blood test, a widely followed federal advisory panel recommended on Monday. Jennifer Corbett-Dooren has details on The News Hub. Photo: AP.

The U.S. Preventive Services Task Force recommended a “D” grade for prostate-specific-antigen, or PSA, testing which has been widely used for almost two decades to screen men for prostate cancer. Previously the task force had recommended against PSA testing for men age 75 and older. Now the recommendation extends to all ages.

A “D” rating means “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits,” the group’s website says. It also is a recommendation “against the service.”

The Task Force report, published Monday online in Annals of Internal Medicine, said PSA screening detects many asymptomatic or slow-growing cases of cancer that won’t cause men any problems in their lifetimes. Treatments for those cancers can include surgery and radiation and can cause side effects such as impotence or urinary incontinence.

“The U.S. Preventive Services Task Force reviewed studies showing the test, widely used for almost 20 years, could lead to unnecessary cancer treatments. ”

The task force said it conducted a review of clinical studies of PSA testing, including a large U.S. study and a European one. The U.S. study didn’t find a mortality benefit. The task force said the European study suggested a small benefit of no more than 1 in 1,000 men screened.

“Many men are harmed by prostate-cancer screening” with a PSA test, said Michael LeFevre, the task force’s co-chairman and a professor at the University of Missouri School of Medicine. “Very few will benefit.” The task force is made up of 16 nonfederal, primary-care providers who review preventative health services and make recommendations, primarily for primary-care doctors.

Dr. LeFevre said the task force recommended doctors could still offer the PSA test if men are informed about the risks and benefits of the test. The blood test is meant to detect a substance found normally in the prostate that is also made by cancer cells. Men with higher PSA scores typically have a higher risk of developing prostate cancer. But the test isn’t perfect, and in some cases follow-up biopsies find no cancer.

In October the task force released a draft recommendation against PSA testing and took public comments. Many doctors who treat prostate cancer worry that the final recommendation will simply keep primary-care doctors from discussing the issue with patients, even those with high risk for the disease such as African Americans or those with a family history. They argue the test can offer important information about which men are at risk for developing prostate cancer.

“There’s a huge difference between over-diagnosis and overtreatment,” said Anthony D’Amico, chief of Genitourinary Radiation Oncology at Brigham and Women’s Hospital and Dana-Farber Cancer Institute in Boston. Dr. D’Amico is co-author of a paper also to be published this week in the Annals of Internal Medicine arguing against the task force’s recommendation.

The American Urological Association recommends doctors and male patients discuss PSA testing, but discourages mass-screening events where the tests are offered free, such as at health fairs, says Ian Thompson, chairman of the group’s prostate cancer guideline panel.

“Men should be informed of the opportunity” to get the test, says Dr. Thompson, who is also chairman of the Cancer Therapy & Research Center at the University of Texas Health Science Center at San Antonio.

The recommendations can influence coverage decisions by Medicare and other insurers, though under current law, Medicare must cover annual PSA testing.

Prostate cancer is the most common non-skin cancer diagnosed in men. The American Cancer Society estimates that 241,740 men will be diagnosed with prostate cancer this year, with 28,170 expected to die from it. Source.

The recommendation by the US Task Force has indeed sparked off wide debate in many quarters. Most doctors, patients and survivors of prostate cancer are against this recommendation. The American Urology Association is one body that doesn’t accept this recommendation even as many men out there who have benefited from the PSA test.

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