When The ""All Clear"" Clears Up Nothing

By Rachael Myers Lowe, cancerpage.com

(February 14, 2005) - Should men be regularly screened for prostate cancer?

A huge increase in prostate cancer screening (made possible by development of the PSA blood test) is responsible for a startling rise in prostate cancer incidence in the US in the last decade, but there’s still debate about whether men at average risk for developing the disease SHOULD be regularly screened for prostate cancer.

The US Preventive Services Task Force (USPSTF), a government sponsored independent panel of experts, says there’s little evidence that early detection from regular screening (as opposed to detection as a result of symptoms) leads to better patient outcomes. In fact the panel concludes: “Screening is associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient"s health.”

The USPSTF seeks to validate the value of new technologies by examining peer reviewed clinical trials and studies. While it’s not ready to endorse prostate cancer screening, it does recommend regular breast cancer screening mammography and colorectal cancer screening.

In December, 2005, researchers at Massachusetts General Hospital reported that nearly half of men given the “All Clear” from a biopsy following a positive PSA still fretted about developing cancer “a lot” or “some of the time.”  Men should be warned about the risks of a false-positive before undergoing a prostate biopsy, lead author, Dr. Mary McNaughton-Collins, concluded.

The American Cancer Society’s director of cancer screening recommends patients have a frank discussion with their doctor about the potential benefits and harm, including incontinence and impotence, associated with prostate cancer testing and treatment.

SOURCES:

• Read the USPSTF recommendation about prostate cancer screening .