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Federal task force: Healthy men don’t need routine prostate cancer screenings

For years, men have been told to have routine screenings for prostate cancer.
Now a government task force is saying, “Nevermind.”
On Oct. 7, the U.S. Preventative Services Task Force released a report that recommended that healthy men under 75 should no longer receive a prostate-specific antigen (PSA) test for cancer because the test resulted in little or no reduction in prostate cancer deaths.
The tests themselves caused unnecessary harm such as bleeding, and anxiety about the test results. Meanwhile, treatment of early-stage prostate cancer caused impotence and incontinence, according to the report.
The task force will provide an opportunity for public comment on the recommendation beginning Oct. 8 through November 11.
“Unfortunately, the evidence now shows that this test does not save men’s lives,” Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force, told the New York Times. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”
Opposition to the task force is most likely to come from cancer survivors, drug makers and doctors. One is Dan Zenka, 53, senior vice president of the Prostate Cancer Foundation, who was diagnosed with prostate cancer in April 2010 and says the screening saved his life. www.pcf.org
“I cannot imagine where I would be today had I missed one of my annual PSA screenings,” Zenka wrote on his blog, mynewyorkminute.org. “THE PSA TEST SAVED MY LIFE. It will continue to save my life as we monitor my response to treatment and watch for signs of recurrence going forward.” http://mynewyorkminute.org/?p=1930
The task force conducts scientific evidence reviews and develops recommendations for primary care physicians and health systems. In 2009, the task force recommended against routine mammograms for women under 50 and said screening for women over 50 should be every two years instead of every year.
The insurance implications of the new prostate screening recommendations may not be immediately felt. But if federal lawmakers agree with the taskforce, they could direct Medicare to change its rules to pay for fewer prostate screening tests.
According to the task force’s report, screening for prostate cancer could cause over-diagnosis due to the detection of “low-risk cancers” that would not wind up being the cause of death. For instance, many of the cancers detected grow at such a small rate that they would never be noticed in a man’s lifetime, yet radiation treatment for these cancers could cause incontinence or impotence, the report said.
According to the Centers for Disease Control and Prevention (CDC), 223,307 men were diagnosed with prostate cancer and 29,093 men died from prostate cancer in 2007, the latest figures available.
According to the CDC, incidents of prostate cancer in men have decreased by 2.4 percent. And the risk of getting prostate cancer increases by age: A 50-year-old man has a 2.3 percent chance of getting prostate cancer before he is 60; A 60-year-old man has a 6.6 percent chance of getting prostate cancer before he is 70; and a 70-year-old man has an 8.5 percent change of getting prostate cancer before he is 80. www.cdc.gov

Kevin Lyons

For years, men have been told to have routine screenings for prostate cancer.

Now a government task force is saying, “Nevermind.”

On Oct. 7, the U.S. Preventative Services Task Force released a report that recommended that healthy men under 75 should no longer receive a prostate-specific antigen (PSA) test for cancer because the test resulted in little or no reduction in prostate cancer deaths.

The tests themselves caused unnecessary harm such as bleeding, and anxiety about the test results. Meanwhile, treatment of early-stage prostate cancer caused impotence and incontinence, according to the report.

The task force will provide an opportunity for public comment on the recommendation beginning Oct. 8 through November 11.

“Unfortunately, the evidence now shows that this test does not save men’s lives,” Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force, told the New York Times. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”

Opposition to the task force is most likely to come from cancer survivors, drug makers and doctors. One is Dan Zenka, 53, senior vice president of the Prostate Cancer Foundation, who was diagnosed with prostate cancer in April 2010 and says the screening saved his life.

“I cannot imagine where I would be today had I missed one of my annual PSA screenings,” Zenka wrote on his blog, mynewyorkminute.org. “THE PSA TEST SAVED MY LIFE. It will continue to save my life as we monitor my response to treatment and watch for signs of recurrence going forward.”

The task force conducts scientific evidence reviews and develops recommendations for primary care physicians and health systems. In 2009, the task force recommended against routine mammograms for women under 50 and said screening for women over 50 should be every two years instead of every year.

The insurance implications of the new prostate screening recommendations may not be immediately felt. But if federal lawmakers agree with the taskforce, they could direct Medicare to change its rules to pay for fewer prostate screening tests.

According to the task force’s report, screening for prostate cancer could cause over-diagnosis due to the detection of “low-risk cancers” that would not wind up being the cause of death. For instance, many of the cancers detected grow at such a small rate that they would never be noticed in a man’s lifetime, yet radiation treatment for these cancers could cause incontinence or impotence, the report said.

According to the Centers for Disease Control and Prevention (CDC), 223,307 men were diagnosed with prostate cancer and 29,093 men died from prostate cancer in 2007, the latest figures available.

According to the CDC, incidents of prostate cancer in men have decreased by 2.4 percent. And the risk of getting prostate cancer increases by age: A 50-year-old man has a 2.3 percent chance of getting prostate cancer before he is 60; A 60-year-old man has a 6.6 percent chance of getting prostate cancer before he is 70; and a 70-year-old man has an 8.5 percent change of getting prostate cancer before he is 80.