Advocates Prepare For Battle On PSA Testing; Insurers Review Options
The New York Times: Panel’s Advice On Prostate Test Sets Up Battle
A day after a government panel said that healthy men should no longer get screened for prostate cancer, some doctors’ groups and cancer patients’ advocates began a campaign to convince the nation that the advice was misguided. Their hope is to copy the success of women’s groups that successfully persuaded much of the country two years ago that it was a mistake for the same panel, the United States Preventive Services Task Force, to recommend against routine mammograms for women in their 40s. This time, the task force found that a P.S.A. blood test to screen for prostate cancer does not save lives, but results in needless medical procedures that have left tens of thousands of men impotent, incontinent or both (Harris, 10/7).
Wall Street Journal: Report Resets Prostate Testing Debate
But few doctors or specialty medical groups said they planned to change their approach to screenings in light of the findings. The American Urological Association said Friday it would continue to recommend PSA screening "for well-informed men who wish to pursue early diagnosis," but it added that any such discussions should include "the risks of over-detection and overtreatment" and make clear that "active surveillance" was also an option. The group is working on new guidelines, and said it planned to take the panel's conclusions into consideration. ... Several physicians said Friday they were already cautious about using the tests, and would continue to be so (Hobson and Burton, 10/8).
The New York Times: Insurers Review Whether To Still Pay For Routine Screening
Insurers and clinicians scrambled on Friday to decide whether to continue to offer routine P.S.A. tests following news that an influential panel of experts no longer recommended them for healthy men. Some insurers said they intended to continue paying for the test, while others said they would revisit their policies (Quenqua, 10/7).
Boston Globe: Men Are Left To Wonder As PSA Test Is Disputed
The disagreement makes clear that ultimately men have to make their own choice. “I’m very confident that different men will make different decisions; I’m reluctant to say one size fits all here,’’ said Dr. Michael Barry, medical director of the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital (Kotz and Johnson, 10/8).
Los Angeles Times: Why Discourage Routine Prostate Cancer PSA Test?
The task force wasn't trying to figure out whether screening for elevated levels of a protein called prostate specific antigen would save any lives at all; the answer to that is clearly yes. Rather, the question before the 16-member panel was whether widespread PSA testing saves enough lives to justify the considerable medical fallout — including loss of urinary control and impotence — to men whose lives are not saved by the test. They said the answer was no (Kaplan and Roan, 10/8).
The Associated Press: New Prostate Cancer Test Advice Overturns Dogma
The idea that finding cancer early can harm instead of help is a hard one to understand. ... The new advice is sure to be hugely controversial. Already some doctors are rejecting it. "We all agree that we've got to do a better job of figuring out who would benefit from PSA screening. But a blanket statement of just doing away with it altogether ... seems over-aggressive and irresponsible," said Dr. Scott Eggener, a prostate cancer specialist at the University of Chicago. In the exam room, explaining the flaws in PSA testing has long been difficult (Neergaard, 10/7).
Los Angeles Times: U.S. Preventive Services Task Force: Who Are These People?
If the world of primary-care physicians had a supreme wizarding council that only weighed in on screening tests and pills promising to head off disease, it would be called the U.S. Preventive Services Task Force. On Friday, the U.S. Preventive Services Task Force recommended against routine prostate cancer screening for men using the prostate-specific antigen (PSA) test, saying that patients are more likely to be harmed by anxiety and aggressive treatment prompted by ambiguous test results than they are to reap benefits such as better health or longer life (Healy, 10/7).
Los Angeles Times: Prostate Cancer: A PSA Researcher Questions PSA Tests
When news came Thursday evening that the U.S. Preventive Services Task Force would recommend that middle-age men forego routine PSA tests to screen for prostate cancer, at least one longtime researcher rejoiced. “I couldn’t agree more with the decision,” said Richard J. Ablin, a research professor of immunobiology and pathology at the University of Arizona College of Medicine who worked on the discovery of PSA, a protein made by the prostate. "It’s a test that really can’t do what it’s purported to do" (Brown, 10/7).
Earlier coverage of the decision on KHN: Task Force Panel Will Urge Men To Skip Prostate Screening, Reports Say
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