Many physicians and treatment centers around the country recommend screening for prostate cancer with a PSA blood test for any men with a history of the disease, symptoms of an enlarged prostate, or who are simply over 50. This test measures how much prostate-specific antigen exists in the blood and will often rise as prostate cancer develops.
However, the United States Preventive Services Task Force (USPSTF) published a draft recommendation in October 2011 stating that there is a high probability that the net benefits of PSA screening do not outweigh the harms associated with prostate cancer treatment, and ultimately discourage all healthy men, regardless of age, from using the PSA test as a screening examination. Understandably, this has created significant controversy in the medical community, as well as among the public.
The recommendation was given after studying over 60 prostate cancer trial cases that either investigated the pros and cons of prostate cancer treatments or utilized PSA tests as a cancer screening tool. From those studies, the USPSTF concluded that a majority of men older than 50 have undergone at least one PSA blood test, but a very small percentage of these patients saw a benefit in their treatment and recovery. However, the Task Force found that many of these men were negatively impacted by prostate cancer treatment and suffered long-term effects such as impotence, incontinence, or complications from surgery.
The USPSTF is not new to controversial recommendations. In 2009, it released a statement that discouraged women under 50 from seeking mammograms and recommended that women over 50 have them done only once every other year, a decrease from the previously recommended annual exam. Because of the backlash from the public and medical professionals, the Task Force now allows for a public comment period and solicits responses to the recommendations before making them final.
Many organizations at the forefront of prostate cancer research and treatment are debating the new recommendation, including the American Cancer Society, the American Urological Association, and cancer treatment centers around the nation. They stress that the benefits of prostate cancer screening, specifically PSA-based testing, have created a significant drop in deaths from prostate cancer over the past two decades. Many organizations want patients to remember that it is also very important to make cancer screening and treatment options as individualized and personal as possible, as every prostate cancer case is different.
Though the PSA blood test isn’t foolproof, it is widely used as the best prostate cancer screening tool available, and advocates of the test believe that the Task Force’s recommendation may stop some men from getting screened for prostate cancer that unknowingly have the disease. The USPSTF has recommended further investigation into prostate cancer screening, treatments, and the long-term benefits of both.
You can read the actual recommendations for yourself here.