Here is an update on prostate cancer screening and PSA. At the time of the largest international meeting of urologists in early May of 2016, new analysis of a study that the US Preventative Services Task Force had used heavily in defending their recommendations has been shown to be highly flawed.
In the study referred to as PLCO that is part of the controversy, two groups of patients were compared. One group was specifically screened for prostate cancer with PSA. In the second group, the patients just had their usual and customary care. Little difference was seen between the two groups as far as deaths from prostate cancer go. However, further analysis shows that PSA was so prevalent that 90% of the control group patients also had PSA testing. Therefore it is not at all surprising that the two groups did not differ much in how things turned out for prostate cancer patients.
A second study which also tried to evaluate the value of PSA screening for prostate cancer (referred to as European Randomized Study of Screening for Prostate Cancer) did show the value of screening, but the USPSTF apparently did not give as much weight to that study in formulating its recommendations.
Apparently USPSTF is in the process of reviewing its prior recommendations about prostate cancer, and hopefully they will realize what just about every single urologist trained and practicing in the PSA era recognize, that PSA should be an integral part of Men’s Health Care. There is no wisdom in banning it…the wisdom is in using it properly, and as a Las Vegas urologist, I believe most urologists have fine-tuned their use of PSA and their decision-making process for biopsies and prostate cancer treatment as well. New genetic testing will also become more available in the near future which will also aid further with such decision-making.