Medical Health News on Reducing PSA Testing: To Save or Not to Save

Reducing PSA Testing

According to Medical Health News, the more lenient the guidelines on regular prostate cancer testing, the higher tendency that tumors will not be promptly detected and treated.

Four years ago, the task force in charge for preventive services in the United States proposed a reduction on the frequency of prostate specific antigen or PSA examination. Given that some treatments only made the situation worse, they argued that this recommendation aims to avoid overtreatment of cancer in the prostate cases. Sure enough, PSA testing has declined drastically by an estimated 28 percent after that.

Were they right? Some low-risk prostate cancer, especially those that are localized, are not terminal. And over-diagnosis might aggravate them and treatment is worse than the illness, sid Assistant Professor Dr. Daniel Barocas, of the urologic surgery of Vanderbilt University Tennessee. Therefore, he added, the move to reduce PSA testing might have had merits all along. In short, men with this kind of prostate cancer can be spared from unnecessary and rigorous treatment.

Or were they wrong? While some cases of prostate cancer are low risk, others are high-risk and there is a higher likelihood of delay in its diagnosis if PSA screening is not administered more frequently. And as a consequence of this reduced screening, there would be missed opportunities for detection and early healing.

These findings will be reflected in the Journal of Urology in its December 2011 issue.

Will the benefits defeat the costs or is it the other way around? Medical news says that according Vice Chair Dr. Kirsten Bibbins-Domingo, of United States Task Force for preventive services, this reduction would bring more harm than good. Based on the proof in 2011 on the testing for prostate illness, especially cancer, the PSA testing can tell whether the cancer is slow-growing or not but it cannot distinguish if it is deadly or otherwise.

Barocas did not agree to the statement. He said that cases among men are relative. Some men having a history of cancer in the prostate in the family, or specific races are more likely to have prostate cancer, according to researches. They should more closely monitor their health, given their higher tendency to the illness than other men. Furthermore, testing should be followed up or accompanied by therapy. Low-risk cases are subject to proper monitoring while high-tendency cases should be given utmost attention.

Was there no other way to detect and distinguish high-risk and low-risk? Since 2011, there had been more high-tech techniques to diagnose prostate cancer. MRI’s and ultrasounds, have been used that can more precisely detect and distiguish and therefore diagnose prostate cancers better and differentiate high-tendency from low-risk cases. These are added considerations, said another expert, Dr. Anthony D’Amico, of the radiation oncology in Brigham and the Boston Institute.

Since then, studies were conducted to look at the result of the modified patterns on the figures and statistics of diagnoses on prostate cancer from years 2010 to 2012.

The result? Diagnoses for cancer in the prostate cases decreased for 1,363 or greater than an estimate of 12 percent of prostate cancer cases in every month right after the guideline has taken effect. From 12 percent, it further dropped to 28 percent on the next year following the date it was issued.

The positive effect? The diagnoses that detect and distinguish between high-risk, intermediate and low-risk levels prostate cancers declined by a very huge margin, but the diagnoses of the kind of metastatic prostate cancer which detects those that are localized or more scattered did not have any effect at all. These are true for all socio-demograhic and economic classifications.

In the following year the modified mandate was issued, opinions of low-risk cancers dropped nearly 38 percent and continued to fall. This implies that for low-risk cancer cases that are not terminal and malignant had been spared from the stress of undergoing rigorous treatment. On the other hand, diagnoses of more aggressive cancer remained the same. This suggests that men who are eligible for treatment are not unaware of the importance of treating the illness. Some diagnoses fell for cancer in the prostate cases in old men above seventy years old and those who will not survive long enough for it to be any.

The negative effect? There was a decline in the diagnoses of moderate-risk degree of cancer and diagnoses of high-tendency level of cancer a year following the date it was published. This is the repercussion that they are trying to avoid: not including those cases that are considered curable.

Based on medical news articles, health is a matter of personal choice. No matter the mandate or the guidelines, everyone is responsible for his or her own welfare.