Group recommends against routine PSA screening for prostate cancer

New recommendations from the US Preventive Services Task Force (USPSTF) on prostate specific-antigen (PSA) screening received heavy coverage both online and in print. Additionally, all three network news broadcasts featured segments on the recommendations, totaling more than nine minutes altogether, making it the most heavily covered topic on their broadcasts. Most sources portray the recommendations as controversial, citing physicians and medical groups who are critical of them.

In its lead story, NBC Nightly News reports on “an enormous game changer in how doctors and patients should now approach prostate cancer. A government panel says doctors should no longer offer routine PSA tests to healthy men.”

The CBS Evening News reported, “A top panel of health experts says that men should no longer get routine PSA tests to screen for prostate cancer. The reason, it says, is that the tests may lead to treatments that do more harm than good.” CBS News medical editor Jon LaPook, MD, said, “The recommendation sparked fury today at the annual meeting of the American Urological Association. In a statement, the group said it was outraged and the recommendation was ‘inappropriate and irresponsible.'”

On ABC World News, ABC News medical editor Richard Besser, MD, said, “I think the task force got it right. It’s not a test for everybody. We do need a better test.”

The Washington Post, “The recommendation from the US Preventive Services Task Force runs counter to some two decades of medical practice in which many primary care physicians routinely gave the…PSA test to healthy middle-age men.” However, “after reviewing all available scientific evidence, the task force concluded that routine PSA screening will help save the life of just one in 1,000 men who get the test.”

Bloomberg News reports, “‘Many men are being subjected to the harms of treatment of prostate cancer that will never become symptomatic,’ the panel wrote.” They added, “There is convincing evidence that PSA-based screening for prostate cancer results in considerable overtreatment.” Bloomberg News adds, “The panel kept its recommendation from October after some doctors and patient groups said discouraging the tests would cost lives.”

On the front of its Personal Journal section, the Wall Street Journal reports that the USPSTF has recommended a “D” grade for the PSA test, which means that “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits,” according to the task force’s website.

The Los Angeles Times reports, “The report, released in the journal Annals of Internal Medicine, was welcomed by some doctors who have worried for years that American men are being over-screened for prostate cancer, leading to unnecessary and often dangerous medical procedures,” but “it dismayed others who believe that the test saves lives and that dumping it would result in more cases of advanced prostate cancer as well as deaths from the disease, which is expected to kill about 28,000 men in the US in 2012.”

USA Today reports, “Unfortunately, there are no other better tests with which to replace the PSA, such as rectal exams, ultrasounds or variations on the PSA, says Ian Thompson, chairman of urology at the University of Texas Health Science Center at San Antonio and a spokesman for the American Urological Association, which recommends the PSA for men over 40.”

In a front-page story, the Boston Globe reports, “The American Cancer Society has no plans to alter its advice — advising men to discuss the benefits and risks with their doctors before making a decision – but its chief medical officer, Dr. Otis Brawley, said he agreed with the task force.”

The AP reports, “The Obama administration said Monday that Medicare will continue to pay for PSA screenings, a simple blood test. Other insurers tend to follow Medicare’s lead.” According to Mark Weber, a spokesman for the Department of Health and Human Services, “This is important information for the public and men to have, and they should talk with their doctors about the risks and benefits of prostate cancer screening and make the decision that’s best for them.”

The Omaha World-Herald reports, “The recommendation goes a step further than the task force’s 2008 statement on the matter. Back then, the group said there was no evidence to support the testing for men over the age of 75.” The Philadelphia Inquirer reports, “The recommendation made no exception for African Americans, who are at elevated risk of developing and dying of prostate cancer.”

The National Journal reports that Dr. Virginia Moyer, who chairs the task force, said, “There is a critical need for a better test — one that leads to early detection of cancers that threaten men’s health, but minimizes unnecessary, risky tests and treatments that do not lead to longer or more healthful lives.”

Also covering the story are the Cleveland Plain Dealer, MedPage Today, Reuters, WebMD, the NPR “Shots” blog, HealthDay, and Medscape.

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