This strikes me as the wrong solution to the legitimate problem of overly aggressive prostate cancer treatment:
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."
Let's be clear here, there's absolutely no risk from a PSA exam. It's a simple blood test. It is not the knowledge that might be learned, that one may have prostate cancer, that is the problem. It's what follows as far as a confirmed diagnosis and the resulting treatment. Now, you can call me crazy, but it seems to me that medical progress would come from fixing the real problems instead of advancing an "ignorance is bliss" non-testing regimen. I know, I'm just silly that way.
I'm getting old enough now to pay attention to this stuff. My dad is in remarkably good health in this regard, but always in the back of my mind is the experience of my maternal grandfather. He was treated for prostate cancer with radiation back in the early 1980s and it resulted in bowel incontinence for the last five years of his life. I have little doubt that he would have been better off going without treatment of any kind. These days we understand more about the different types and stages of prostate cancer and there are better treatment options, though those side effects are still very real risks.
Generally speaking, prostate cancers are slow growing. It seems to me that a reasonable approach to take for most men is a routine digital exam and barring any abnormalities or other symptoms, a PSA test every two years or so. From what I gather even that is not supported in the new report. That's going to kill some people who have the more aggressive form of the disease. It is especially going to hit hard if doctors stop offering it and insurance companies decide to stop paying for the test altogether. It seems inevitable to me that the result will be many more prostate cancers discovered at much later stages.
This new policy will be good for those who end up not going through unecessary treatments, but it's going to suck for those who die early because this panel cut off the test that would have caught their cancer.
Can't we do better for both groups? That's what I want and that's what we should demand. It may be difficult to achieve, but we should expect the medical community to at least try.