A reduced PSA Screening recommendation made by the US Preventive Services Task Force (USPSTF) in 2012 that downplayed the importance of screening for prostate-specific androgen, or PSA, has had the disastrous but not entirely unexpected result of an increased number of men being diagnosed with more aggressive forms of prostate cancer.
Unintended Consequences
The USPSTF certainly didn’t intend for the incidence rate of aggressive prostate cancers to increase based on their recommendations. However, a recent research study published in the World Journal of Urology discovered a major difference in men diagnosed before 2012 versus those diagnosed after the recommendation went into effect. In particular, higher-grade cancers, which were discovered only 6.2 percent of the time before 2012, were now found to be 17.5 percent of the time instead.
Researchers found even further proof that using PSA screening as a tool to identify and diagnose possible cases of prostate cancer earlier during the lifecycle of the tumor. Lower-grade cancers, prior to 2012, were found at a rate of 30.2 percent, yet post-recommendation lower-grade cancer rate discovery dropped to just 17.1 percent.
Fixing the Problem
With both high-grade cancer rates increasing and lower-grade ones decreasing, it’s clear that the lack of PSA screening is playing a negative role in men’s health. It’s imperative for urologists, oncologists, and other medical experts to begin relying on PSA screening in greater numbers to ensure that an otherwise undetectable prostate tumor goes untreated, developing into a more serious and aggressive form.
The USPSTF originally devalued PSA screening based on a number of factors, including the possibility of false positives and having to undergo possibly unnecessary testing and prostate biopsies. However, the evidence presented has more than shown the drawbacks of reducing or eliminating PSA screening for men could be disastrous and clearly outweigh the benefits of a small subset of men having to deal with misdiagnosis.
Taking everything into account, it may be much preferable to a patient to be told they have prostate cancer and then be told later that they don’t instead of the other way around.
