Federal panel advises against prostate cancer screen for men

Introduction

An influential federal task force has finalized its view that men should avoid a controversial test for prostate cancer that was the subject of a Center for Public Integrity investigation last fall.

The U.S. Preventive Services Task Force advised men against routine prostate cancer screening using the prostate-specific antigen (PSA) blood test because the test often leads to more harm than good. The group found that, under the best of circumstances, one man of every 1,000 given the test would avoid death as a result, while one in every 3,000 would die prematurely from complications related to prostate cancer treatment. Prostate cancer is common, particularly in older men, and often cancers discovered through screening grow so slowly that they would likely not cause harm.

The task force findings, published Monday online in The Annals of Internal Medicine, follow similar draft guidelines that were issued by the group last fall. The Preventive Services Task Force is a group of 16 primary care providers who review preventive health services and make recommendations — recommendations that are closely watched by the medical profession.

Not everyone agrees with the findings. The American Urological Association issued a statement saying it is “outraged and believes that the Task Force is doing men a great disservice by disparaging what is now the only widely available test for prostate cancer, a potentially devastating disease.”

The current debate surrounds the value of the test, but the cost of the test to government health plans has also been the subject of scrutiny. Last fall, the Center reported that 40 percent of Medicare spending on common cancer screening procedures — including the PSA test — is probably unnecessary. Cancer screening tests are widely overused, the probe found, in part because doctors disregard scientific evidence out of ignorance, fear of malpractice suits, for financial gain or in response to patient demand.