WAPC Responds to Updated Recommendations on PSA Screening

As you have probably seen by now, last Friday the U.S. Preventive Services Task Force (USPSTF) released draft recommendations downgrading prostate specific antigen (PSA) testing to a “grade D recommendation.” In other words, they recommend against screening in healthy men that “do not have symptoms that are highly suspicious for prostate cancer, regardless of age, race or family history.”

We find these recommendations highly troublesome. Since the use of PSA began in the early 90’s deaths from prostate cancer have gone down. And prostate cancer still kills over 32,000 men each year. A recommendation against screening will discourage men from having an informed discussion with their physicians about whether they should consider prostate screening given their individual risk.

We strongly believe that PSA testing in combination with a digital rectal exam, when properly translated, can be an important tool in helping to diagnose prostate cancer. While we remain very hopeful hopeful about the promise of new and better biomarkers that are in the pipeline to help accurately diagnose and discern between aggressive and non-aggressive prostate cancers, PSA is the best tool we have right now.

As you may know, early prostate cancer often has no symptoms and If we wait until men start to see symptoms for prostate cancer then it is likely that it will be found in it’s advanced stages when treatment is less likely to be effective.

More education is needed to let men know that not all prostate cancers are aggressive and that a man can choose to treat or utilize active surveillance, but a man has a right to know if he has cancer in order to make an informed decision on how to move forward.

Betty Gallo, Co-founder of WAPC shared, “The USPSTF sites concerns about over-treatment of prostate cancer, but prostate cancer screening in itself does not lead to over-treatment. More work needs to be done to educate men about the option of active surveillance as well as the side effects that may accompany some forms of treatment. I am firmly convinced that if PSA had been routinely in use when my husband, former Congressman Dean Gallo, was alive his cancer would have been caught early and he may still be with us today.”

We encourage men and their loved ones to engage in an informed discussion with their doctor about whether PSA screening is appropriate for them, especially men who are at high risk, including African American men, men with a family history, and veterans exposed to Agent Orange.

We encourage you to make your voices heard on this topic by:

  1. Reading the recommendations set forth by the USPSTF.
  2. Sending your comments to USPSTF.
  3. Writing a letter to the editor of your local newspaper expressing your concern over the new recommendations.

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Comments (3)

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  1. I was a man who thought he was ‘healthy’ until being diagnosed by a chance blood test. The following DRE and Biopsy showed metastaic prostate cancer in february 2006.
    I would like to know the USPSTFs definition of a ‘Healthy Man’.
    To address the problem of overtreatment they should take a look at the trigger point for treatment (PSA, Gleason) and perhaps highering the bar so that we have more careful monitoring of the men who fall into the ‘grey area’ who typically have a Gleason 6 and a PSA less than 10.
    I believe a recent study showed that highering the PSA trigger to 20 produced a massive reduction in overtreatment.
    Without a test for prostate cancer more men will DIE.

    At least I was diagnosed when I had time and mobility to organise my life and make preparations for those I will leave behind a time which has been so precious and rewarding in many ways.
    I will not deny my three sons the possibilty of a cure, they WILL have regular PSA or other tests.

    Keith (the red sock campaign)

  2. I believe a recent study showed that highering the PSA trigger to 20 produced a massive reduction in overtreatment. just sayin….

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