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Prostate Cancer Screening: Not So Fast
When you look at screening diagnostic tests to detect the presence of disease, nothing causes more discussion than colonoscopies for colon cancer, mammograms for breast cancer, and prostate-specific antigen (PSA) screening for prostate cancer. I was recently at a presentation by a colleague on diagnostic screening tests and whether they are worth it. The discussion that ensued was charged with emotion and logic but eventually it was decided that we as healthcare providers need to provide our patients with the relevant statistics and evidence and then allow them to make their own informed decisions.

Today, the U.S. Preventative Services Task Force released recommendations for prostate-specific antigen (PSA) screening in the Annals of Internal Medicine. The report gives PSA testing a “D” grade level and recommends that men should not have  routine screening for prostate cancer using the PSA test. The task force based their recommendations on several studies which show that there are 242,000 new cases of prostate cancer diagnosed in the U.S. each year and 28,000 men will die each year of it. The majority of deaths occur after age 75 years and the PSA test only helps 1/1,000 avoid dying from prostate cancer. The bottom line in the report is that the test itself causes more harm than benefit because the majority of men, who develop prostate cancer, die of other causes. Prostate cancer surgery leaves between 10 – 70 per 1,000 men with the quality of life altering adverse effects such as urinary incontinence, erectile dysfunction, and bowel dysfunction (Moyer, 2012).

Whether you agree with the recommendations in this guideline or not, the fact of the matter is that this is a recommendation not written in stone. We need to discuss this recommendation with our male patients and then honor their decisions.

Reference:
Moyer, V. 2012. Screening for prostate cancer: U.S. preventative task force recommendation statement, Annals of Internal Medicine, May 22, 2012.
 
Submitted by:
Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC
Chief Nurse and Publisher
Wolters Kluwer Health / Medical Research Division
Lippincott Williams & Wilkins / Ovid Technologies


Posted by Lisa Morris Bonsall on 5/22/2012 1:52:38 PM with 0 comments

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