WASHINGTON, DC, Nov 6 — Eight years ago the U.S. Preventive Services Task Force was recommending against PSA testing for prostate cancer. And now a new analysis by the Centers for Disease Control [CDC\ shows that metastatic prostate cancer is on the rise, reports the Association of Mature American Citizens [AMAC].
The study showed that “although approximately three-fourths of US men with prostate cancer have localized stage at diagnosis, an increasing number and percentage of men have received diagnoses of distant stage prostate cancer. Survival with distant stage prostate cancer has improved, but fewer than one-third of men survive 5 years after diagnosis.” [Localized prostate cancer remains in the prostate gland while distant stage prostate cancer is metastatic; it spreads to other parts of the body.]
Meanwhile, research conducted by Urologists, Dr. Navin Shah and Dr. Vladimir Ioffe, shows that “after the United States Preventive Services Task Force (USPSTF) recommended against PCa [prostate cancer] screening, there was a trend of increasing prostate cancer diagnoses with higher grades despite a decrease in overall biopsy rates. We found that in 2019, compared to 2010-12, the number of biopsies decreased by 45% while the diagnosis of PCa increased threefold.”
According to Dr. Shah: “Prior to 2012, annual PCa screening reduced PCa mortality by 50%. Since the USPSTF recommended against PSA- and DRE-based PCa screening [Digital Rectal Examination], 50% of primary care physicians do not offer PCa screening.”
In its report, the CDC noted that “In 2018, USPSTF issued a new recommendation stating that prostate cancer screening for men aged 55–69 years should be an individualized decision based on personal preferences when weighing the benefits and harms of screening, and several professional organizations have similarly recommended shared decision-making for men deciding about prostate cancer screening. Understanding incidence and long-term survival by stage, race/ethnicity, and age could inform messaging related to the possible benefits and harms of prostate cancer screening and could guide public health planning related to treatment and survivor care. Further research is needed to examine how social determinants of health affect prostate cancer diagnosis and treatment; findings should inform interventions to decrease disparities in outcomes.”
So why did the USPSTF recommend against PSA testing in the first place? According to a Harvard Medical School report there may have been three reasons:
“American man’s risk of developing prostate cancer at some time in his life is at least 30%, yet his risk of developing clinically important disease is about 17%, and his risk of dying from the disease is only 3%. In other words, many prostate cancers are harmless even if untreated; a man is much more likely to die with prostate cancer than from it.
“The PSA test cannot tell which cancers are likely to be indolent and which are aggressive. That means routine screening will detect many tumors that would never cause harm, a problem called overdiagnosis.
“About three of every four men with PSAs above 4.0 ng/ml do not have cancer. That’s because benign prostatic hyperplasia (BPH), infections, inflammation, and other conditions can boost PSA levels, while many other conditions can lower PSA readings.”
About AMAC: The 2.1 million member Association of Mature American Citizens [AMAC] [https://www.amac.us] is a vibrant, vital senior advocacy organization that takes its marching orders from its members. We act and speak on their behalf, protecting their interests and offering a practical insight on how to best solve the problems they face today. Live long and make a difference by joining us today at https://amac.us/join-amac.