For more than 20 years, I’ve been warning about the downsides of PSA (prostate-specific antigen) screening for prostate cancer. There’s a very high rate of false positives and rampant over-treatment. But it took years for medical experts to admit it doesn’t work—and in fact is harmful.
The US Preventive Services Task Force has waffled for years. First, they concluded that “the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years.” Then, in August 2008, this group urged physicians to stop testing PSA in men 75 and older.
Now, they’ve finally admitted routine PSA screenings don’t work. The Task Force gave the test a “D” for accuracy and recommended that it no longer be used as a screening tool. They cited the huge number of false positives and unnecessary surgeries. Folks, you don’t need a task force to tell you that—the evidence was clear and I set the record straight more than two decades ago.
But all of this foot dragging isn’t surprising. False high PSA rates have been a huge cash cow for the medical community. Since PSA testing became commonplace, more than a million men have been treated for prostate cancer—men who, if not for an elevated PSA test, would never have had surgery and/or radiation treatment. These treatments aren’t benign, and can result in impotency, incontinence, and in some cases death.
So, what should you do? Instead of PSA testing, I recommend the tried-and-true digital rectal exam. If a doctor can feel cancer in the prostate, it’s most likely significant and merits follow-up. Hopefully, more doctors will follow the Task Force’s advice and stop testing every man who walks through their door.
Also, come back on Friday when I’ll share what I recommend if you’re diagnosed with prostate cancer.
Now it’s your turn: What’s your opinion on the Task Force’s findings?