A government task force is recommending that men should stop receiving a routine blood test to check for prostate cancer because the test does more harm than good. At best, the prostate specific antigen (PSA) blood test will save one life out of 1,000 men tested, but another man will develop a dangerous blood clot, two will have heart attacks, and 40 will become incontinent or impotent because of unnecessary treatment.
The U.S. Preventive Services Task Force made this proposal to drop routine screenings last fall, and it’s sticking by the final guideline despite outrage from the medical community.
Not every form of prostate cancer needs to be treated because most of the cancers found through the PSA blood test are slow-growing and unlikely to cause harm, so a member of the task force said better ways to detect prostate cancer will help:
The controversy will end only with development of better tests — to finally tell which men’s tumors really will threaten their lives, and who will die with prostate cancer rather than from it, said Dr. Virginia Moyer of the Baylor College of Medicine, who heads the task force.
“We have been told for decades to be terrified of cancer and that the only hope is early detection and treatment,” she said. The reality: “You don’t need to detect all cancers.”
“We don’t want this to be the answer,” Moyer added. “We want to screen for the ones that are going to be aggressive, manage those early — and leave everyone else alone.”
Even with the new guidelines, it is unclear how many men will skip testing. The task force already recommends that men over 75 skip the blood test, but research shows that about half still have it. And for those who test positive and learn they have have prostate cancer, low-risk patients often choose aggressive treatments with few benefits, according to a 2010 study.
Overall, unnecessary health costs add $158 billion to the nation’s health care tab each year, and the Affordable Care Act invests in comparative effectiveness research to help determine the most cost-effective course of treatment to cut down on those unnecessary health costs. And to cut down on overtreatment, the task force’s guidelines to cut out PSA blood tests that do more harm than good — and lead to sometimes unnecessary treatment — are a good place to start.
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