Earlier this month, three medical professionals posted their thoughts about the connection between the drop in prostate cancer diagnoses and an overall reduction in the administration of the PSA test. The editorial by three medical professionals – Meir Stampfer, MD, DrPH, Brigham and Women’s Hospital and Harvard Medical School; Mary Downer, Brigham and Women’s Hospital and Harvard Medical Schools; and Matthew Cooperberg, MD, MPH, Helen Diller Family Comprehensive Cancer Center – was published in the Journal of American Medical Association.
Freelance writer Pam Harrison wrote a synopsis of the above mentioned article, which was published on Medscape, a news site focused on improving patient care with important relevant information and resources for physicians and healthcare professionals. (It is from Harrison’s article that this blog post is crafted.)
Fewer PSA Tests Equals Less Early Detection of Prostate Cancer
In what is written as an editorial, Downer, Stampfer, and Cooperberg expressed concern that despite the raw data of fewer diagnoses, the existing number of cases (diagnosed and undiagnosed) is not actually going down. Rather, more cases are going undetected, and a higher percentage of the cases diagnosed are being detected in later stages due to a combination of:
- Tests being conducted as the result of symptoms and
- The 2012 recommendations of the U.S. Preventive Services Task Force, which discouraged routine PSA tests due to the number of mild, non-life-threatening cases that were being aggressively overtreated by the medical community.
In short, according to the authors, there are fewer diagnoses because fewer PSA tests are being administered than in the recent past – when the death rates from the disease were languishing at historical lows.
The authors were candid in their concerns, according to Harrison’s synopsis. Harrison quoted the original article:
“But for prostate cancer, changing rates largely reflect screening practices and do not reflect the enormous prevalence of undetected prostate cancer,” they add — an estimated 42 million US men today have undetected prostate cancer. Fewer than 3 million have been diagnosed with prostate cancer.
More Information: A Better Approach
Dr. Stampfer was clear in his desire to see a return to more regular use of the PSA screening: “The PSA test is a simple blood test. It provides information that is reliable, but it doesn’t automatically trigger an inexorable set of steps leading to surgery or radiation.” He continued (in the article), “So by not having the PSA test, basically you are throwing away the potential for information, which always seems like a bad idea.”
Read the original article online: http://www.medscape.com/viewarticle/880457