Many Men Plan to Ignore PSA Test Guideline: Survey07/09/13
TUESDAY, July 9 (HealthDay News) -- Most older American men plan
to get screened for prostate cancer despite a recent recommendation
that many should just skip the controversial PSA test, a new survey
The authors of a report about the survey don't reveal which side
of the debate they're on, although they do write that new PSA test
research suggests that its "harms outweigh the benefits."
Overall, the survey shows that "we need to do a better job of
presenting both the benefits and harms of screening to all
patients," said report lead author Linda Squiers, a research and
evaluation methodologist with RTI International, in Research
Triangle Park, N.C. "We also should explain the science behind the
recommendation in plain language so everyone can understand
At issue is a 2012 recommendation by the U.S. Preventive
Services Task Force regarding prostate cancer screening. It now
says men of all ages who haven't been diagnosed with prostate
cancer shouldn't get the prostate-specific antigen (PSA) test. The
guideline "is based on science and rooted in the knowledge that
while everyone wants to help prevent deaths from prostate cancer,
current methods of PSA screening and treatment of screen-detected
cancer are not the answer," the USPSTF website states.
Critics of the test say it often picks up signs of prostate
cancer that are not dangerous, potentially leading to unnecessary
and harmful treatment. "You'll often find disease that isn't
aggressive and will never harm you. But your doctor, your wife,
your relatives will put you under pressure to treat that cancer,"
said Andrew Vickers, an attending research methodologist at
Memorial Sloan-Kettering Cancer Center, in New York City.
Prostate cancer treatment can lead to incontinence and
impotence. But, of course, treatment can also prevent death from
Some physicians say the test is useful, and many continue to
give it to patients, in some cases without consulting them.
For the new report, researchers used an online survey to tell
1,089 men aged 40 to 74 about the task force recommendation -- it
was in draft form at the time of the survey in 2011 -- and ask them
if they planned to follow it. None of the men had been diagnosed
with prostate cancer.
The researchers then adjusted the results, adding more or less
weight to certain answers in order to better reflect factors such
as the nation's mix of age, race and education.
Only 13 percent of the men planned to follow the recommendation
notget a PSA test. Fifty-four percent said they'd ignore the
recommendation and get tested, while one-third of men were
undecided, the investigators found.
Blacks, wealthier men, those who'd had a recent PSA test, and
those who were at least somewhat worried about prostate cancer were
more likely to plan to get a test.
Why are many men ignoring the recommendation even when they're
told about it? "It is wishful thinking by the men and urging by
their physicians that causes the problem," said Dr. Anthony Miller,
professor emeritus of epidemiology at the University of Toronto's
Dalla Lana School of Public Health.
For his part, Vickers, the methodologist at Memorial
Sloan-Kettering, said men seem to have a "misapprehension" about
the value of the test and the risk of unnecessary treatment. "Many
people think 'If I don't get screened, I will die of cancer. But if
I do get screened, I won't,'" he said.
The best approach is to let patients make the call about PSA
tests, he said, after making sure they're well informed about the
benefits and risks.
The report appeared online July 9 in the
American Journal of Preventive Medicine.
Visit the U.S. Preventive Services Task Force to see its
recommendation on prostate cancer screening.
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