Tuesday, February 14, 2012

PSA Screening—One Man at a Time

The U.S. Preventive Task Force released a new draft recommendation that PSA screening for prostate cancer is no longer appropriate. The concern was that the risk of complications and unnecessary surgery outweigh the potential benefit of catching a cancer early. Large studies showed no significant benefit in reducing mortality. An editorial in the New England journal disputed the action, and I agree with the authors. A PSA for screening should not be a required test, but serial measurements for individual men should be an option, along with digital rectal exams, after a careful discussion with the doctor about the potential risks and slight benefits. Individualized medicine addresses the needs of every person. Statistics are a guide but they should not direct us to throw the baby out with the bathwater if there is a reasonable chance of benefit for an individual patient. See New England Journal of Medicine (click here) subscription required. 2011;365:1951-1953.

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