“It can be hard for physicians to follow current thinking of experts on medical care. It must be exponentially harder for the public to make sense of it. Recently, the United States Preventative Services Task Force changed its recommendation on prostate cancer screening from a D (that is, don’t do it) to a C (discuss it with your doctor)”. What does this mean for you?
Experts used to believe that the risks of screenings, like false positives, outweighed the ‘small’ benefits, but with more data, experts now lean toward the advantages of screening. Technically, this is a good thing. With more advancing technologies, our thinking about prostate cancer screening advances and evolves, as well. On the other hand, constantly changing opinion about whether or not testing should occur discredits these experts in the eyes of many patients. They argued that over-diagnosis leads to to unnecessary treatments, and a newly discovered cancer could lead to no symptoms or harm over the patient’s lifetime. The treatments for prostate cancer, including radiation and prosatectomy, have high levels of adverse effects like impotency, incontinence, or both.
It’s important to note that these changes apply only to men 55 to 69. For men 70 and older, the harms outweigh the benefits, and the screening recommendation remains a “D.” In reality, what has changed is the likelihood that a doctor is going to recommend screening for PSA. Patients and their doctors must decide themselves whether or not to test based on the patient’s preferences and circumstances.