Increasing cases of advanced prostate cancer, criticizing PSA screening criteria

To understand why the message about prostate cancer screening has changed so much, it is important to know its history.

Dr. Gary Kirsh, President of the Urology Group Screens for Specific Types of — Prostate specific antigen (PSA) screening Made by blood tests — at the heart of the medical debate.

“In the early stages of the PSA test, many previously undiscovered cancers were discovered, and there were many treatments for previously undiscovered early-stage cancers,” Kirsh explained. “As a result of that treatment, these treatments had some side effects that men had not previously experienced in large numbers.”

At this point, the US Preventive Services Task Force (USPSTF), a panel of experts who make recommendations for physicians, focused on PSA screening methods.

The USPSTF determined that the benefits did not outweigh the risks and recommended them in 2008 for PSA screening of men age 75 and older.

In 2012, the Task Force revised this limit to include all men.

Finally, in 2018, the guidelines were revised again to recommend for PSA screening in men over 70.

Kirsh explained that there are some benefits to decision-making as PSA testing can diagnose early-stage cases of the disease, potentially encouraging potentially unnecessary treatment and biopsy.

“The problem with such thinking, though to some extent, is that doctors were unaware of their ability to change and understand trial use over time,” he said. “What happened was that the USPSTF threw the baby out in the bath water. A few years later, the chicken returned to the roost and recorded a change in the amount of the disease it now prevents in an incurable state. I’m starting.”

As a result of the change in guidelines, PSA test rates have declined.

by Amedin Jemal, DVM, PhD, lead author of research, and Vice President of Science for Surveillance and Health Services at the American Cancer Society, with potentially fatal tradeoffs in recent years.

“These data show the trade-off between higher screening rates and earlier stage disease diagnosis (probably overdiagnosis and overtreatment) and lower screening rates and later stage (probably fatal) disease. Dr. Jemal wrote in the study.

Kirsh states that the USPSTF’s modified guidelines have eliminated many good practices for many doctors from detecting early cases of prostate cancer.

Overdiagnosis is the number one concern for the USPSTF panel, but experts say that PSA testing remains important in detecting early cases of the disease.

“This is a test that should be used in conjunction with wisdom, and that wisdom is that not all people with elevated PSA need to undergo a biopsy, and more importantly, a small amount of early non-invasive People with sex prostate cancer don’t need it, they will be treated,” Kersh explained.

“Detecting cancer before it has spread can mean the difference between curable and uncurable life and death.” Jamie Bears, CEO ZERO – President of The End of Prostate Cancer. “The PSA test is similar to a female cervical smear in detecting cervical cancer, but it has a significant amount of false positives and false negatives. Nevertheless, the PSA test is safe. Yes, it is the only effective first step to detect prostate cancer.”

Steven EisenbergDO, a California oncologist specializing in prostate cancer, told Healthline that the potential risk of a PSA test does not rule it out.

“There were concerns about overtreatment of early prostate cancer,” he said. “But with reduced screening, a small number of cases are detected in the first stage. Indeed, fewer early diagnoses can prevent overtreatment. But higher percentages of men are more advanced. It is expected to appear in stages.”

Eisenberg supports a measured approach to bridge the gap between overtreatment and the lack of potential diagnosis.

“In my opinion, thoughtful communication and a personalized approach are the best,” he said. “For example, men screened early based on several factors and diagnosed with a less aggressive disease can be followed closely with active surveillance.”

Kirsh emphasizes that the USPSTF guidelines were a sincere effort by task force experts, but were ultimately misguided.

He now says that it is possible to quantify the damage done using several years of data.

However, because toothpaste cannot be put back into the tube at this time, medical personnel say the damage needs to be corrected as it progresses.

“Really, the only thing we can do is public education, and this new study is important, along with other studies,” Kirsh said. “We need to disseminate information about what has happened in the last decade to get the attention of the general public and doctors.”

Eisenberg says patients and doctors need to form “strong partnerships” and have open dialogue on related issues.

“The big issue is the need for conversation that covers individual intelligent screening,” he said. “These discussions should start at the age of 50 for most men. People with a family history, or African American, The conversation should start early in the 40s. “