On an edition of ABC World News recently, Dr. Richard Besser reported that “there’s a big change in store” for prostate cancer screening. He went on to say, “Since 1997, the American Cancer Society (ACS) … hasn’t routinely recommended the PSA test, but most doctors have done it. Now they’re saying you need to have a conversation between you and your doctor before that test is done.”
The Los Angeles Times reports, “New (ACS) guidelines … emphasize that physicians should better educate men about both the risks and benefits of using the PSA test for screening.” The ACS “also urged greater use of education specialists, pamphlets, videos, and other materials.”
The AP reported that the ACS “wants doctors to talk to men and give them plenty of information before they have a PSA test to make sure they understand its limits.”
The new guidelines follow recent findings that the “PSA test may lead to unnecessary treatment for many men,” because “the test can’t clearly indicate whether a cancer is aggressive or harmless.”
PSA blood tests can “lead to false readings that require additional tests and biopsies … said” lead author Andrew Wolf, a physician at the University of Virginia, Bloomberg News reports. “If patients do choose to be screened with PSA blood tests, those with low levels can safely be screened every other year instead of every year as suggested previously, according to the new recommendations.”
The Houston Chronicle reports that “the guidelines also urge doctors to … make the digital rectal exam an option rather than using it as a standard screening tool” and to “base the frequency of PSA testing on previous scores.”
And, although the ACS does not “call for eliminating mass screening events,” the group recommends including “high-quality information upfront of screening’s potential risks.”
So, what are most men in my practice who are age 50 and over choosing? Most are choosing to have the PSA blood test (which should ALWAYS be done with a digital rectal exam). But, they are more informed than in the past of the potential risks of doing so.
To explore two sides of that debate, read Benefits of PSA Test Are Exaggerated and PSA Cancer Screening, Much Like a Seat Belt, Is a Wise Choice for Men.