Task force: PSA tests do more harm than good
May 21st, 2012
05:28 PM ET

Task force: PSA tests do more harm than good

The United States Preventive Services Task Force issued their final recommendation on the PSA prostate cancer-screening test Monday, recommending against routine PSA exams for men of any age. The task force says the PSA exam and additional treatments that may follow, like radiation and surgery, result in far more harm than benefit.

Dr. Virginia Moyer, who sits on the task force, cited that only one out of every 1,000 men who are screened would actually benefit from the exam. Instead, most will have to deal with side effects from treatment that can range from incontinence and impotence, to stroke and death.

“Your primary care physician shouldn’t routinely offer the exam," said Moyer. "But if a patient brings it up, that doctor has a responsibility to inform them of the potential harms and risk."

New story: Top American Cancer Society doctor weighs in on the announcement

However, the American Urological Association is not changing its stance on the PSA test.  “We at the AUA still recommend the PSA, with its imperfections," said Dr. Chris Amling. "It’s the wrong thing to deny a man if he wants to have this test."

Related: Value of mass prostate cancer screenings questioned

The PSA test measures the amount of prostate-specific antigens in the blood. While the screening detects the presence of prostate cancer, it cannot make the distinction between aggressive, fast moving cancers, and the more common slow growing ones.

“There is no other screening test for prostate cancer. It’s clear that the only way to cure prostate is to detect it early," Amling emphasized.

Related story: Annual prostate cancer test doesn't save lives, study says

According to the American Cancer Society, prostate cancer is the second deadliest cancer among men, and occurs most often in African-American.  But survival rates also are very high. The American Cancer Society finds that 91% of all men with prostate cancer will live for 15 years beyond diagnosis. According to the National Cancer Institute, 70% of prostate cancer deaths occur after age 75.

Dr. Otis Brawley, Chief Medical Officer of the American Cancer Society supports the recommendation of the task force.  “People need to realize that science hasn’t given us the answer," said Brawley. "In the past, when we don’t have a scientific answer, and we’ve guessed, we’ve hurt a lot of people."

Related story: Who decides about screenings?

The task force made its draft recommendation publicly available in October 2011, and reviewed nearly 3,000 comments before issuing its final recommendation.

soundoff (566 Responses)
  1. mbonadio

    The PSA test can be a life saver... At 40 my PSA was elevated after my GP ordered it tested during my physical. I disagreed initially, but after a year it hadn't gone down – only up, regardless of what I tried naturally. So I agreed to a biopsy. Guess what – it showed cancer. Fortunately for me I had the cancer dealt with and am now 42 and cancer-free. The cancer was found before it spread and was fully contained. Bottom line is that everyone has a right to their own decisions regarding health-care choices. It's not the government's decision on who gets treated and why. It's the medical community that needs to publish the right guidelines and for you to take responsibility for your own family's well being.

    May 22, 2012 at 09:36 | Report abuse | Reply
    • nicthalon

      Just a little FYI – the United States Preventive Services Task Force is NOT government, and is NOT tied to insurance companies, and their findings are supported by the CMO of the American Cancer Society. Nobody said the test was useless, only that it should not be pushed as an annual preventative. In your case, it did its job and probably saved your life. Congratulations! This doesn't mean that the test is a good idea for everyone. That is the point of the study.

      May 22, 2012 at 13:03 | Report abuse |
  2. Say what?

    I am 50 and I routinely get the PSA test done as part of my annual blood work. I want the results so I, along with my doctor, can make an informed decision about what to do. IF I do not have the information, then any decision is taken out of my hands.
    It seems the problem is not the test, but that the doctors are not educated on the proper next steps.

    May 22, 2012 at 09:36 | Report abuse | Reply
    • Well

      said...it's not the test it is what happens next that is the problem.

      Ignorance is not bliss.

      May 22, 2012 at 09:47 | Report abuse |
    • asdf

      The problem IS the test. The results are not always accurate, and as a result people feel forced into undergoing ultimately unnecessary surgeries with very serious risks.

      May 22, 2012 at 10:01 | Report abuse |
    • PublicHealthScientist

      re: asdf.

      I don't see your reasoning, vis-a-vis the postings of Say What and of Well to which you are responding. It seems to me that if it (your argument) were applied, say, to railroad crossing warning signs, it would be claimed that they are dangerous. Almost always they give a "false positive", in the sense that there is no train about to enter the intersection; and therefore they should be done away with lest people keep stopping (when they come to a RR Xing warning sign) and waiting for a train to pass. "It's better to just let drivers drive along and not tell them about the crossing. Very few of them will get hit, and we avoid making drivers feel compelled to stop." But aren't the warning signs in fact useful, because they cause drivers to be vigilant and look for an approaching train? No, we don't want every driver to stop and wait; just as it evidently is not wise to go cutting and/or radiating just because a PSA is high. But isn't it better to know that, well, one factor is in place (that one would expect if there were a cancer in the prostate)?

      I'm glad to know that I'm approaching a RR Xing; or that the atmospheric conditions are "right" for a tornado to develop, or that a bear has been spotted in the area, etc. Why dis the tests and warnings, when the problem (as pointed out by the earlier posts) is that the next step taken by some [OK–by many] is ill-advised? Foster better next steps...

      Or, am I missing something crucial to your argument?

      May 22, 2012 at 13:52 | Report abuse |
  3. ray

    how is the psa test harmful? the test itself is 100% benign. this is all about obamacare making choices for you!

    May 22, 2012 at 09:43 | Report abuse | Reply
    • asdf

      This has nothing to do with Obama. People have had concerns that the risks of the PSA outweigh the benefits for years. Somebody finally started counting and realize that they almost never catch anything, it's often a false positive, and people were going under the knife and becoming sterile or incontinent for no reason.

      May 22, 2012 at 10:00 | Report abuse |
    • jnpa

      It has nothing to do with Obamacare. Get over it.

      May 22, 2012 at 10:23 | Report abuse |
    • PSA OK

      @bonehead: Men's health has nothing to do with your ultra-narrow-minded views on the President of the United States. Find a filthy street corner to spout your worthless hate.

      May 22, 2012 at 10:34 | Report abuse |
    • fintastic

      It's a BLOOD TEST..... how is that harmful??...... another article written by morons.

      May 22, 2012 at 10:36 | Report abuse |
    • fintastic

      Insurance companies again...... there ya go.....

      May 22, 2012 at 10:39 | Report abuse |
    • Walter

      fintastic and ray, can you not read? The only thing wrong with the test is that its often false positive. That means nothing if you ignore it, but if you have surgery and have a side effect and then later find out that the test was wrong, you just went to surgery for nothing. Reading is fundamental.

      May 22, 2012 at 10:43 | Report abuse |
    • Chris R

      Fintatsic, Ray, The problem isn't with the blood test. The problem is with how people deal with the results. Let me lay out a scenario for you – You have a 65 year old an who comes up with a positive PSA test. He has a decision to make. He can get the cancer investigated and treated or he can do nothing. The treatment (not the test) comes with a risk of some real side effects. The most common are incontinence and impotence. Less common but more serious side effects include stroke and death. Currently, laproscopic prostatectomy has a 15% complication rate. So one of seven men will face some negative side effects from surgical treatment. Now, if this 65 year old man does nothing there is a 91% chance he'll still be alive in 15 years. In fact, it's far more likely that heart disease will kill this person than his prostate.

      So if you look at the odds and the quality of life issues it really kind of makes more sense to either not treat the prostate cancer or take a *much* less aggressive approach. The problem is that this guy isn't thinking rationally. He has CANCER! CANCER growing inside of him! He's going to want it taken out *now*. Yu can show him the statistics but his fear will make the decision for him.

      Now, consider that scenario multiplied millions of times. What you end up with is a large number of men getting unnecessary procedures with a high number of them facing life long issues that serious impact their quality of life. All this to treat something that, in all likelihood, will not have any impact on them, their quality of life, or when they die. It's a situation where the cure is often worse than the disease.

      This isn't, obviously, true in all cases and some very small percentage of men end up with an aggressive form of the disease. However, if you look at the *larger* picture routine testing – especially for people with no family history or risk factors for the disease – you end up with a vast amount of pointless suffering, wasted procedures, and lost money.

      May 22, 2012 at 11:16 | Report abuse |
    • dave A

      This is NOT about Obamacare as you put it. Nice try to politicize CANCER.

      May 22, 2012 at 11:31 | Report abuse |
    • goobernutt

      @fintastic..You are so right, it's a blood test that measures the PSA. I have just been diagnosed with Prostate Cancer and it was due to that simple blood test. Followed by another blood test to confirm the high PSA levels are not a fluke and eventually a byopsy which validated that it is cancer. The 4 options that my doctor presented was 1. Seeding the cancerous areas in the prostate (Radiation Pellets) 2. External Radiation treatment (over a 5 week period externally directing radiation at the cancerous area) 3. Surgery (Radical Treatment – just cut it out) and 4. Do nothing and monitor my prostate and the cancer. By the grace of God it appears they caught mine early, but it was also due to my doctor constantly testing me due to my age, and just being a good family doctor who was looking out for his patients best interest, you know, the way it's supposed to be.

      May 22, 2012 at 11:52 | Report abuse |
  4. Mike

    At age 47 I went in for a routine physical and my primary care recommended that I have my PSA checked as part of my bloodwork. My PSA came back elevated so over the next 18 months I had was monitored by a urologist and had 3 biopsies. The third biopsey showed that 3 out of the 12 samples were positive. He referred me to Johns Hopkins Hospital for a second opinion. The doctors at Hopkins laid out my options. My wife and I decided that surgery was the best option. Fifteen years later, I am still not incontinent or impotent and am cancer free. I often wonder where I would be now if not for my doctor recommending getting my PSA checked. According to the averages I guess I wouldn't be writing this comment.

    May 22, 2012 at 09:49 | Report abuse | Reply

    Thank you United States Precentative Services Task Force, BUT I'll go ahead and have the screening test anyway, and if the screening shows that I have cancer, I will make a decision on my treatments options with the advice of MY physicians, not yours. I'm perfectly capable of making these decisions without your assistance. Oh, and for your information, most people (myself included) have a zero tolerance policy on cancer, so I don't really care if most people don't benefit from these screenings.....the only person it has to help is me. Oh, and since prostate cancer screenings begin well before the age when people become eligible for Medicare, it's not like the government is the one footing the bill for the screening tests,......so what business does a government task force have even discussing the issue? These are tests that are primarily paid for under private insurance (which was purchased by the patient) or out of the patient's own funds, so as long as my doctor still thinks it is worth the hassle and expense to have the test done (and I still agree with his opinion), then I could care less what this or any other task force thanks about it. Believe their position is primarily based on a cost-benefit analysis Looking at the total cost of providing the tests to all patients and the relatively few people who are diagnosed with a treatable form of cancer because of the tests. When my life is in the line, I don't care how much a test costs, and I certainly dont care about how much money other people wasted on tests that didnt find cancer or didn't find a treatable cancer.

    May 22, 2012 at 09:49 | Report abuse | Reply
    • AK

      The 'cost' isn't the cost to the government, but the cost to you, in medical payments, and potential side effects like incontinence etc. etc. The science points to the fact that the test isn't always accurate, intervention doesn't always help, and can sometimes have undesired side effects. The decision is still yours. The task force is recommending against the PSA test, not telling or forcing you to do anything.

      May 22, 2012 at 11:25 | Report abuse |
  6. JohnG

    I don't get this at all. The PSA test is simple and not terribly expensive. Yes, it is just an indicator of possible prostate problems (not just cancer), but as an indicator it can be confirmed with a digital rectal exam and can prompt more precise testing like a biopsy. This is exactly what happened to me, and the biopsy showed cancer that was aggressive but in an early stage, still confined to the prostate. It was treated successfully – I am completely cured, with no incontinence and no loss of sexual function, and my life won't be one day shorter than it would have been otherwise. With any cancer, early detection is the key and the PSA is a tool for early detection.

    May 22, 2012 at 09:51 | Report abuse | Reply
  7. Richie_A

    I can't say that I didn't see this coming, but someone needs to pay for the Health Care Act and this is just the tip of the proverbial iceberg. Next will be a recommendation to only see the dermatologist once every 5 years since you'll be more likely to die of a heart disease before having that pre-cancerous growth removed.

    May 22, 2012 at 09:53 | Report abuse | Reply
    • PSA OK

      See @bonehead comment above.

      Perhaps you should go comment on finance dot yahoo dot com and buy stock in tin foil for hats?

      May 22, 2012 at 10:40 | Report abuse |
    • InOhio

      So only 1 in 1000 men will die of prostate cancer, and that will be 10 years after their workling life (i.e. contributing to the government coffers) and women with breast cancer won't last long after their working life ends either. Think about the 1 in 1000 odds and if you want to take that chance, please forgo your PSA test so my husband can have his. In fact, any man who doesn't think a PSA test is necessary can donate his test to a man whose family cares if he lives longer than 75.

      It is also being suggested that women should not get mammograms before the age of 50, and I understand that it is suggested women should not have mammograms after the age of 65.

      BTW for anyone who does not know, the mammogram at age 4o is generally considered to be a 'baseline' mammogram. If there is no baseline and cancer is developing, there will be no way to compare what is normal with what is not. Of course, if the cancer is left to grow until age 50, the life of the patient will be ending soon anyway.

      And most breast cancers, per a ammogram imaging tech, are discovered over the age of 65.

      The government will however authorize pain pills to ease the patient's end of life suffering.

      May 22, 2012 at 11:13 | Report abuse |
  8. topaz114

    My father had his prostate removed & radiation/chemo at age 59 (super high PSA). Years later he said he regretted the decision because of side effects that ruined his quality of life. He told my husband that it sucks and he wouldn't recommend ever having that done. My father-in-law had a mass on his prostate, and instead of prostate removal, he had the radioactive seeds put in. He had no side effects and is very happy with the result.

    May 22, 2012 at 09:57 | Report abuse | Reply
  9. Hot Carl

    Nothing like the old fashioned finger up the coolie for me.

    May 22, 2012 at 10:03 | Report abuse | Reply
  10. Todd

    Wow, how cynical has everyone become? No one is making decisions for anyone. This isn't about obamacare, this isn't about the government controlling your life. This task force's purpose is to protect people's health by providing information about currently used procedures. The statistics they have gathered show that most people do not benefit from PSA tests, especially with the ages prostate cancer usually presents so they do not recommend that doctors push PSA exams on the masses. Does this mean there isn't outliers like some people here? No, and that's fine. You can still request the test, and because of this task force the doctor will have to discuss both positives and negatives of the test. In my eyes, this sounds like the better option.

    May 22, 2012 at 10:05 | Report abuse | Reply
    • fintastic

      Yes, you can request the test BUT INSURANCE WON'T PAY FOR IT!!!!!......

      what a Friggin joke...

      May 22, 2012 at 10:40 | Report abuse |
  11. Bill192NJ

    The original, rejected headline for this piece was:
    'Old Age: Overrated?'

    May 22, 2012 at 10:13 | Report abuse | Reply
  12. taskmaster

    Virginia Moyer is part of Obamas death squads. Prostate cancer kills mostley older men. That is what the Obama administration wants.They want the older people off of social security and medicare.Then there will be more money for welfare, medicade and food stamps.The more older people they can kill ,the more money Obama has for his chosen. Following the example of Nazi Germany. Watch the further tests these "death squads" will determine are not needed. They will all affect older people.

    May 22, 2012 at 10:16 | Report abuse | Reply
    • jnpa

      Your comment is strange...you are strange.

      May 22, 2012 at 10:25 | Report abuse |
    • PSA OK

      Are you actually serious, or are you just a mentally-constipated hatemonger?

      May 22, 2012 at 10:41 | Report abuse |
    • fintastic

      Step away from the crack pipe......... quite the imagination you have!

      May 22, 2012 at 10:41 | Report abuse |
    • TG

      Taskmaster, you are one ignorant FOOL!!

      May 22, 2012 at 11:09 | Report abuse |
    • dave A

      You are one sick puppy!

      May 22, 2012 at 11:33 | Report abuse |
  13. TallinOK

    This panel recommendation is very dangerous. I would imagine there was a lot of pressure from the administration to reduce the number of blood tests so that Obamacare and private insurance companies would not have to pay for them.

    As a prostate cancer survivor, if I hadn't had my PSA checked every six months (family history) I would have been in at least Stage 2 by the time it would have been diagnosed. Once prostate cancer gets out, it can attack other parts of the body (that's what is really dangerous about the panel's recommendation).

    I prefer the belts-and-suspenders approach. Get the PSA and a DRE (flying fickle finger of fate) at least once a year if you are over 35 and/or have a family history of prostate cancer.

    This is nothing to mess with!

    May 22, 2012 at 10:21 | Report abuse | Reply
  14. Pappa Smurf

    Hmmm anyone remember a few months ago that an org recommened that women didn't need a breast exam every year? So now we have this for men... and some of you think that this dosen't have anything to do with Obama care?

    May 22, 2012 at 10:23 | Report abuse | Reply
    • PSA OK

      You are stunning. Someone let out the sphincter-breath closed-minded America-hater people today.

      Short bus much?

      May 22, 2012 at 10:43 | Report abuse |
    • Rbnlegend101

      I dropped a piece of toast yesterday, and it landed butter side down. Then today, my cat knocked a glass off the table and it broke. I think we all see where this is going. Obamacare. Not only that, I was trying to do a puzzle, and couldn't figure out the right answer. That has to be Obamacare, if not Obama directly. I think that the president probably got on that website, and messed with the puzzle so it's unsolvable.

      May 22, 2012 at 11:12 | Report abuse |
    • Doug

      No, this research has been going on for 10 years. Cost analysis is the future of medicine. If someone has a mutation that has a poor prognosis, they are less likely to get treated. Welcome to the future...

      May 22, 2012 at 12:24 | Report abuse |
  15. Harold

    Exactly a year ago based on rising PSA tests my father had a biopsy which revealed an aggressive Gleason 8 cancer; with radiation treatment he appears to be cancer free today. If not for this test, we'd probably be burying him within a year or so. I also have a history of fatally aggressive prostate cancer on my mother's side of the family; you better believe I'll continue getting yearly PSA tests even if I have to pay for them out of my own pocket.

    May 22, 2012 at 10:24 | Report abuse | Reply
  16. Rumpel Stiltskin

    The problem is we need better, cheaper, simpler tests. We don't need NASA exploring deep space for NO reason other than to do it. There is plenty here we can spend our money on to make ALL our lives better.

    May 22, 2012 at 10:28 | Report abuse | Reply
    • Chris R

      The computer you are typing this on, the network you are using to post this message, and many other things around you are a direct result of NASA doing things for 'no reason'. NASA engages in basic research. That sort of basic research is the foundation of the applied research and engineering that results in products and advances that improve your life on a daily basis.

      May 22, 2012 at 11:26 | Report abuse |
  17. J.R. Templer

    The PSA test is simply a blood test. According to my first two urologists, it's not a very accurate indicator. The danger lies not in the test, but rather with the overreaction of doctors to the results of the test. If you want a reliable prostate exam, go to your urologist once a year, drop your pants, bend over the table, and grit your teeth as the original meaning of the term 'digital' inserts itself into your consciousness.

    May 22, 2012 at 10:29 | Report abuse | Reply
  18. PSA OK

    I am tested annually. I will continue to do so. I'd rather know. Dad, his dad, and his dad had prostate cancer. I'm not leaving my wife and kids behind for the wrong reasons: I'm tested for skin and prostate cancer and am glad of it.

    If the results ever show positive, it will be a long, deliberate process to determine if anything is to be done about it. Likely, I will wait another year and do another test and discuss it with multiple docs that don't know each other.

    May 22, 2012 at 10:36 | Report abuse | Reply
  19. Will LeRoy

    I had not heard about a PSA until my doctor recommended it. I had a test at age 55 and the score was high. I had a biopsy and discovered I had cancer, stage 3. I selected the treatment option based upon research and today at the age of 61, by the grace of God, I am cancer free. I have numerous male friends and colleagues who have the exact same story. No federal agency should recommend a policy that would have any influence whatsoever of any GP to fail to mention to their patient the various cancer screening tests available to individuals that might indeed save their lives. The PSA is the ONLY test available and saves lives. Their research is dangerous, suspect at best, and patently absurd.

    May 22, 2012 at 10:41 | Report abuse | Reply
    • Todd

      I'm not doubting that it saved you and your friends, and that's great. You can't really think that your research of you and your friends can match up to the tons of research published in peer-reviewed journals that was used in making this report? Most doctors agree with their findings and agree the test is suspect, heck even the CMO of the American Cancer Society. Even with these statements made by the task force, it is still your right to get the test if you want to which is great for people that want to. All they are saying is it should not be recommended for the masses because the risks outweigh the benefits.

      May 22, 2012 at 10:54 | Report abuse |
  20. ceg10

    Test is what saved a couple of long time friends of mine. They found the cancer changing aggressively. That was 4 years ago. The surgery didn't leave any side effects. The medical robot surgically removed the prostate without damaging any of the nerves. Both claim that they are fully functional. BTW both of these guys are in their 40s and without test I seriously doubt either would have live to see 75........

    May 22, 2012 at 10:45 | Report abuse | Reply
  21. Peter Poopy

    This story is almost unbelievable if true. If this is true its an earth shaker since Prostate cancer is the leading cause of death from cancer among men... ....youre saying that the PSA chemical test is no good? Or are you implying that there is no real way to determine what the nature of the Cancer is? The reason I am shocked is that if there is no real reliable treatment for this cancer the battle against cancer is a complete failure. This is the most common form of Cancer among men. Are you saying that Men should just live with their fate? "Hope I die before I get old" lol

    May 22, 2012 at 10:57 | Report abuse | Reply
    • Todd

      The problem isn't the treatment, it's the test itself. It's not a good test, but it is all we have. The USPSTF's reason for being is to review practices and procedures. In doing so with the PSA, they have found through peer-reviewed journal published research along with over 3000 comments from other health professionals and still came to this conclusion that the risks far outweigh the benefits for MOST people. That being said, there are still some people that may benefit from this test but shouldn't be recommended for everyone until the test is perfected and more reliable. It's not obama's war on men, or obamacare or anything of that nature. This task force is looking for the general well-being of people and this report officially shows the need to improve the PSA test because of how problematic the disease is.

      May 22, 2012 at 11:08 | Report abuse |
  22. leonard

    This is another assault in the Obama administrations war on men, because it leaves men without any method to detect the disease that kills more men the any other. Also,if men should not be making decisions about breast cancer, why is a female on this board.

    May 22, 2012 at 11:00 | Report abuse | Reply
    • Chris R

      Leonard, heart disease kills *far* more men then prostate cancer. Heart disease kills around 340,000 people each year. Prostate cancer kills around 32,000. Which is about the same number of men killed each year by the flu. It's a big number but not the leading cause of death. It's not even the leading cause of men's cancer deaths each year.

      May 22, 2012 at 11:19 | Report abuse |
    • Kent

      While I'm not an afficianado of the President, from experience I have to agree with this piece. This is beyond politics (mostly).

      This smells of Medical bilking.

      My entry to the prostate-PSA-biopsy-world starting in 2010 with a rising PSA from 3.9 (in 2009) to > 4.1. This resulted in a biopsy (benign), but I was relieved. However, in 2010 my PSA went up fast (I can attribute that to accute stress at that time) to 6.6. An antibiotic to treat inflammation was given, but lowered it to 5.6. I had another biopsy in Feb 11 – benign.

      This year in March it's 6.4. The doctor wants to do another biopsy. When doing the math: two-biopsies, no-symptoms, albeit with a slowly rising PSA, a biopsy looks more risky than not.

      I had 26 needles biopsy me already. That result shows a lower risk in place of cancer. It's not a 100% gaurantee, but my risk of dieing from Prostae cancer now is about 1-2%. More biopsies based soley on PSA would be more dangerous.

      A biopsy is a serious proceedure, but urologists seem to do it freely, almost is if they were panning for gold.

      I should mention that my first biospy resulted in dehydration and and ambulance trip that day to the emergency room for hydration. I also had anxiety attacks, and flashbacks for days afterwards (I was awake on the first one)

      Further Example...
      My stepfather as 87, who was beginning to pass on the the next world: was given a biopsy and we were told that he had "prostate cancer".....WHY was this done to a dieng man?: curiosity and a billable procedure.

      May 22, 2012 at 11:29 | Report abuse |
  23. Pete

    The PSA test finds 1/1000 and extends a life. The problem is that Americans can only afford tests for 1/100 life threatening conditions. At some point we are going to have to chose between food and shelter and super life extending medical care. The costs keep going up and we won't have the funds to pay for the insurance or care.

    May 22, 2012 at 11:10 | Report abuse | Reply
    • Rbnlegend101

      No, the test finds some number of positives out of each 1000, 1 of which is an actual life in danger. That life is extended. Of the other positives, most get an unpleasant medical experience, and some number get side effects and complications. If that number is 1 death, the whole process balances out. If it's more than 1 death, the test is a bad idea. The panel, which examined all the results, decided the test is a bad idea. But, sure, it's probably about cost. Undetected untreated cancer is probably pretty cheap, and much more desirable for everyone. That last bit is sarcasm, by the way.,

      May 22, 2012 at 11:21 | Report abuse |
    • Pete

      I want a weekly PSA so I can have the best chance of a cure when I get cancer. There is a cost for this level of detection and early treatment. The non-medical political question is who is going to pay for my super standard of care? Should I expect the health care system to pay for my expectations? Should others have to pay for test frequencies that might find a 1/000 cancer?

      May 22, 2012 at 11:38 | Report abuse |
  24. james

    All of this is focused wrong. The real danger is the biopsy which can bleed like crazy, and in an otherwise small area of cancer gets spread by disturbing it with needles etc. The PSA test is actually useful..by keeping yearly tabs on the numbers you get what is called velocity. You can see a sudden sharp change..then I suggest non-invasive ultra sound to look. Also tell your Dr. to stick his finger up his own a s If you have urine problems and youre over 50..it is simply BPH..very normal.

    May 22, 2012 at 11:13 | Report abuse | Reply
  25. C.Major

    Excellent recommendation based on scientific evidence. The AUA has financial incentive to offer PSA and to give the unnecessary treatment that follow and elevated test reading. The fact is that PSA is a lousy predictor of prostate cancer. We as patients need to demand tests that identify which cancers to treat, and which ones not to treat.

    May 22, 2012 at 11:15 | Report abuse | Reply
  26. richard40

    Sounds to me like the problem is not the PSA tesst itself, but how they react to it. If you have a positive PSA, it does not mean you automatically have cancer that must be removed. There should be 3 steps:
    1. Do a biopsy to see if any cancer is present.
    2. If cancer is present, the biopsy should also tell you whether it is an agressive form that must be treated, or a slow growing form that could be safely ignored if you are old.
    3. You should only have cancer treatment if the biopsy actually varifies cancer, and it is the fast growing kind.

    As long as this protocal is followed, the worste that can happen with false positives from the PSA is some unecessary biopsies. So the report citing unecessary cancer treatment is not a problem with the PSA, but with the physicians that used it. The worste that should have occured is an unecessary biopsy, which is not that expensive or that invasive.

    May 22, 2012 at 11:16 | Report abuse | Reply
  27. Bails

    This test saved my husbands' life. It was only thru the thoroughness of our primary care physician that he had the PSA test run. His PSA level was 26! 26!!! It turned out to be cancer, and thru surgery, it was revealed that some of the cells had likely breached his prostate. But today we celebrate over six years cancer free for him. I shutter at the thought that this test may not be offered or made available to our two sons!! Please don't give us this news!

    May 22, 2012 at 11:16 | Report abuse | Reply
    • Chris R

      No one is going to take away the test. That's not what this report is about. It's just a recommendation based on large amount of research that yearly PSA testing does more harm that good for most people. This is how science works – we come up with an idea (yearly PSA testing is a net good). Then we research it and look at the data we collect. Then we say "Okay, it looks like our initial assumption was wrong. What do we do about that?". We then modify our original idea (what about testing only once every 5 years?) and test that. The cycle repeats itself until we come up with a premise that is supported by the facts. This is how science is supposed to work.

      The reason why this is controversial is because medicine often doesn't follow the scientific process. The *vast* majority of physicians are not trained as scientists and they aren't given any training in the scientific method. They often work by anecdote and guess work. What we are trying to do is inject modern medicine with modern science in order to provide the best outcomes to patients.

      May 22, 2012 at 11:24 | Report abuse |
  28. Rbnlegend101

    Doctors love to do stuff. And the great thing for them is, if they do something, and the patient lives, they saved the patient. Even if they didn't have to do anything. So, if they order a test, and it says "maybe", they get to do a proceedure, and bill for it, and if the patient lived, they saved the patient. No proof that the patient was in danger, just a maybe.

    Some tests result in more treatement, and treatment related death, than the actual condition. In that case, you do the test less often. That makes sense. And all the people here who post their anecdotes still don't add up to evidence or statistics. The plural of "anecdote" is not evidence. Part of the psychology of the experience is, once you have had the test, and the proceedure, you are convinced it saved your life, and that's hard to argue with. You had a miserable hospital experience that you are convinced saved your life, if it didn't that's a lot of money and suffering wasted, so, you defend it to the hilt. Still not evidence.

    May 22, 2012 at 11:17 | Report abuse | Reply
  29. peter

    At first, I thought the headline said TSA Prostate Exams! What a relief that is...

    May 22, 2012 at 11:40 | Report abuse | Reply
  30. Doug

    This is the future of medicine: Determining what is effective and what is not due to cost cutting measures. I see it at my hospital and I hear speakers every month talking about specific mutations that don't warrant transplants or further treatments (I work in oncology, bone marrow transplant). But, on the other hand, doing this research and cost analysis makes the system run smoother and conserves resources all while giving patients a definitive prognosis and letting them know just how 'serious' their condition is...

    May 22, 2012 at 11:47 | Report abuse | Reply
  31. ProbeOhPhobe

    They just want to stick their finger up my hooey. Noooo thanks.

    May 22, 2012 at 11:47 | Report abuse | Reply
  32. TTE

    This "journalist's" article makes no sense. If they don't understand the AP source and can't do research to put out a coherent piece, then don't write it. Get a job at a car wash where you'll do some good. How can a test cause harm? How can someone go "under the knife" based only on blood levels – wouldn't there be an actual biopsy if next steps were required? What shoddy writing.

    May 22, 2012 at 11:51 | Report abuse | Reply
  33. Randy

    PSA test for me indicated cancer and biopsy verified it. Since neither can determine the aggressiveness of the cancer, why would I do nothing? Sure the odds of it being aggressive are not the norm, but if there is no way to determine the aggressiveness why would I gamble on my life?? Even if not agressive, why would I still not want to get rid of it. Terrible recommendation!! I was young for prostate cancer (52). Why would I take a chance on living 15+ years rather than 30-40 years? Never can convince me the PSA did not save my life short-term or long-term as I had prostatectomy and the cancer was confirmed to be confined to the prostate. Really did not want to wait for it to spread whether it be in 15 days or 15 months or 15 years.

    May 22, 2012 at 11:52 | Report abuse | Reply
    • Jeff

      My situation was exactly the same, except I was diagnosed at 39 (and no family history). Two biopsies confirmed, and I had a prostatectomy – I still had half my life ahead of me, so I opted to have the diseased organ removed. The surgeon found three tumors in the prostate. I'll be clear 10 years in July, and I continue to have PSA tests done once a year (as well as the finger test) just to make sure it hasn't returned.

      May 22, 2012 at 12:55 | Report abuse |
  34. taskmaster

    Tg: Thats what the jews were told when they tried to tell the world what was coming in Germany. Who turned out to be "ignorant fools" ? This is only the tip of the ice burg. There are aready plans in place for a panel to decide WHO will receive any kind of cancer treatment if they are on medicare. But it wont stop there.Your turn is coming.

    May 22, 2012 at 11:53 | Report abuse | Reply
  35. Betsey

    I have an idea. If you don't have an MD, PhD, ScD, or DrPH, how about you not automatically dismiss things you don't understand?

    Why do people think because they have bodies they somehow know as much as the experts? We don't do this with other things. If Ford tells me to change my oil every 5,000 miles, I don't say, "well, you used to say every 3,000 miles so now I think you are just trying to kill my car." If the firemen say, "Don't use elevators during a fire" we don't scream that they are taking our choices away. What is it about public health that makes people think that they a.) don't have to show any basic respect or b.)don't have to show any basic understanding?

    And, for the record, I am faculty at a top 10 public health school in the US. Everyone I know in cancer control has known that PSA test do more harm than good for years. If people want to be mad about something, be mad about the fact that we don't have better diagnostic tests. How about you channel your outrage into writing a letter demanding more funding being spent on developing a better diagnostic criteria for breast, cervical, and breast cancer? Let's stop wasting our money on a test that doesn't save lives and causes much harm and spend it on developing tests that actually work.

    May 22, 2012 at 11:58 | Report abuse | Reply
  36. Cowboy

    Face it baby boomers. There's too many of us & they have to find ways to thin the herd.

    May 22, 2012 at 12:00 | Report abuse | Reply
  37. testing

    I think i met the guy that invented that. He was mad because he thought the company that he worked for was trying to steal it from him. I think they kept it and fired him. It would be interesting to know what happened after that. It became the big test of choice there for a while.

    May 22, 2012 at 12:03 | Report abuse | Reply
  38. Paul

    Yes, the psa test can lead to a biopsy and that test tells you if you have cancer, its stage and how aggressive the cancer is. People don't go into radical procedures without biopsies and good reason. I'd say an aggressive cancer of your prostate is a good reason and ealing with the side effects is not as bad as dying early.

    May 22, 2012 at 12:05 | Report abuse | Reply
  39. Brian

    I feel so lonely out here. I wish I could not see what is coming, but I always seem to. This administration knows that the government (me and you) cannot afford ObamaCare. Therefore, cuts have to be made. He did it 1-1-11 with coding for routine care making it very difficult to get certain bills paid. Then they said that women did not need mammogram's over age 40, going against all we have known in the past 50 years. Now it's us with PSA. What will happen is that you will still be able to get the tests (for now), but because of these recommendations, the state insurance pools will not pay for it, thereby cutting health care costs. They had to start with issues that will not incite the American people. It is called the Frog In The Pot method. If you put a frog in a hot pot of water, it will jump out. If you put a frog in a cold pot of water and then start heating it up, it will not recognize that it is in trouble and will boil to death never jumping out. As this administration squeezes out all facets of the health insurance industry to assure success of it's ObamaCare plan which will make America dependent on the government in yet one more way and a serious step toward Socialism, most people are sitting in lukewarm pots not knowing it. God, please help us all, even those who cannot see.

    And to set the record straight, I excitedly told a friend of mine long before O became popular that we would have to watch what this guy does because he is a great orator. We did watch. We did keep our eyes open and did not buy into the emotionalism of his campaign. We were shocked by the crowds of racist people who voted for him strictly because he was half black (according to CNN 99% of all blacks voted for O). We were shocked by the crowds that thought they were being magnanimous voting for him because he was black – they felt self satisfied that they were politically correct forgetting that this man was actually going to run our country. And he will again, I fear. "I will have more flexibility after the election" he said to the Russian ambassador when he did not know the microphones were still on – O is giving them the oil rich islands off the coast of Alaska and permitting them to build an underwater bridge from Russia (China lives next door) to Alaska. WHY? People please think before you are not permitted to do so.

    May 22, 2012 at 12:10 | Report abuse | Reply
    • scot

      Man you are so out of touch with reality ! These statements are from the people that you want in our goverment not the government. Yes it does cuts costs but who are the cost cutters ? You have been voting for them and listening to their BS and believeing it !

      May 22, 2012 at 13:03 | Report abuse |
  40. cbpelto

    It's a damned BLOOD TEST!!!! For cry'n out loud. What's the 'harm' in blood tests? People get them all the time for checking diabetes and other disorders. If we shouldn't test for PSA, we shouldn't do blood tests for much anything else.

    May 22, 2012 at 12:39 | Report abuse | Reply
  41. cbpelto

    P.S. Who IS this 'quack' and WHY are my tax dollars going to her?

    May 22, 2012 at 12:41 | Report abuse | Reply
  42. Name calistus

    God is able

    May 22, 2012 at 12:43 | Report abuse | Reply
  43. Mike

    Discontinuing PSA tests is a bunch of garbage. Because of a PSA test, prostate cancer was discovered, the cancer was successfully removed and I am alive today. If PSA tests weren't routinely done, the cancer would have kept on growing and spreading, and I might be dead today if not for the test. I don't believe this recommendation that it is not needed. Is the panel paid off by the medical insurance companies?

    May 22, 2012 at 12:50 | Report abuse | Reply
  44. scot

    The test saved my life. I had elevated PSA tests but due to the last "privite insurance mandated governmental statements " I waited to see what it was at my next annual. It went up 5 pts over the elevated privious years. I had the bi op and it showed cancer. When I had it removed they said I was lucky because it was at the point that it was ready to go outside the encapsulated area. SO get the test done and LIVE !

    May 22, 2012 at 12:58 | Report abuse | Reply
    • Pete

      Scot: You are 1/1000 outlined in the article. Good for you, but now are you willing to pay for the same level of care that gave you a positive result? What I am asking is that you would pay more for insurance or in government taxes to meet the 1/1000 expectation.

      May 22, 2012 at 13:14 | Report abuse |
  45. mk2010

    Use PSA to screen, and biopsy to confirm Prostate CA. what is wrong with that?

    May 22, 2012 at 13:09 | Report abuse | Reply
  46. Trevor

    The cure to preventing PC – M@sturb@te. Constantly.

    May 22, 2012 at 13:27 | Report abuse | Reply
  47. ajb

    When I was 49, I was diagnosed with prostate cancer at a very early stage (3+3), thanks to a PSA test and two follow-up biopsies. The doctor told me that the cancer could be a threat in 15 years, and he would recommend doing nothing if I were in my 70s, but since I was relatively young I should have it taken care of (which I did). If I had waited 15 years until symptoms started showing up, surgery would have been riskier (since I was older) and the cancer could have spread. The problem is, the study they're basing this recommendation on followed some men for only 10-13 years. How could that study have been able to detect cases where a cancer would have become life-threatening 15+ years in the future?

    May 22, 2012 at 13:36 | Report abuse | Reply
  48. Sm2012

    I am 57 years old had the PSA done and it was 7.4. I opted to take the radiation for 9 weeks every day except on the weekend. I went to the doctor 3 2 months later and it had dropped to 3.5. I have another appointment next month and expect the PSA to continue dropping. The only side effects I have is burning when I urinate and the fatigue other than that I feel ok.

    May 22, 2012 at 13:36 | Report abuse | Reply
  49. dandapani

    ObamaCare is right. I didn't have prostate cancer until I got that dang PSA test. I was healthy up to that very moment. Hey, perhaps PSA tests cause cancer. That's it. That's the ticket. Morgan Fairchild...

    May 22, 2012 at 14:14 | Report abuse | Reply
  50. Paul from New Haven

    Sure, you had a PSA test, and it indicated a cancer, so you had surgery and you lived. That's just so great for you.

    The problem is, that for most people, the cancer wouldn't have killed them–they wouldn't even have known about it. Instead, they made themselves impotent and incontinent for no good reason.

    The point is, there are still ways to diagnose dangerous prostate cancers that really need to be treated, primarily the DRE.

    The PSA finds a boatload of indolent low-risk cancers, but when men hear the C word they run to a surgeon screaming "get it out! get it out!"

    May 22, 2012 at 16:58 | Report abuse | Reply
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