In a decision that has already provoked a reaction, an American expert group ransacked today a popular blood test for risk prostate cancer, saying its use is doing more harm than good.
the healthy men need not be examined by measuring the levels of prostate specific antigen (PSA) outstanding concludes Preventive Services Task Force of the United States, an independent group that advises the United States government. Men can pass the test, according to the panel because it is unreliable: Based on the trial data, it prevented some deaths at best potentially 1 in 1,000 screened men. Yet the working group estimated that for every 1,000 men screened, further medical treatment leaves with a blood clot, two with heart attacks related to the treatment and up to 40 with impotence or urinary incontinence. Overall, the working group does not think that the benefits of PSA screening are worth supporting.
The final recommendations are a great change from the previous position of the working group in 08. At the time, the group held an equivocal view, saying that although the men over 75 years should Skip the PSA screening, the benefits for the young men were "uncertain". After reviewing recent clinical trials, however, the working group scrapped its language covered and approved a negative light. He now says he "recommends PSA screening for prostate cancer," regardless of age. The working group notes that this notice does not apply to men who have been diagnosed with or are being treated for cancer; the working group explained that it did not examine PSA monitoring for these patients
the urology specialists were prepared for these new and secured with an angry response "L.. American Urological Association (AUA) is outraged by [the task force’s] no change recommendations "published last year in draft form, the association said in a statement released today by the President Sushil S. Lacy, professor . of urology at the University of Nebraska Medical Center in Omaha He called today's announcement a "disservice to the American people":
It is inappropriate and irresponsible to publish a declaration of coverage against PSA testing, particularly for at-risk populations, such as African-American men. Men who are healthy and have more of a life expectancy of 10-15 years should have the choice to be tested and not discouraged from doing so. There is strong evidence that PSA testing saves lives. ... Instead of loading the primary care physicians to discourage men to have a PSA test, the Working Group should focus instead on how to counsel patients about their risk of prostate cancer.
The chairman of the working group, pediatrician Virginia Moyer at Baylor College of Medicine in Houston, Texas, acknowledged in a prepared statement that "there is a critical need for better [prostate cancer] test-one that leads to the early detection of cancers that threaten men's health, but minimizes unnecessary, testing and risky treatments that do not lead to more or healthier life. "In a commentary published with the recommendations in Annals of Internal Medicine , it calls for more research on ways to distinguish slow cancer progression in those rapidly fatal and potentially find best ways to alter PSA test used to reduce the high number of false positive results.
the controversy over PSA tests reflects some of the same concerns about government oversight of medical practice that arose in 09 when the same workgroup (but with members) lowered the value of mammography as a means of preventing breast cancer death. as these guidelines, the prostate cancer guidelines can be debated in Congress. already the Urological Research Foundation, whose medical director, William Catalona of medical school at Northwestern University, opposed the recommendations of the working group, is to tell readers of his website: "It is very important that you let your representatives in Congress know how you feel about these recommendations. "
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