Each year some 30 million American men undergo testing for prostate-specific antigen (PSA), an enzyme made by the prostate. Approved by the Food and Drug Administration in 1994, the P.S.A. test is the most commonly used tool for detecting prostate cancer along with a digital rectal exam (DRE — note, the two should ALWAYS be done together for prostate cancer screening).
In an op-ed in the New York Times, Richard J. Ablin, a research professor of immunobiology and pathology at the University of Arizona College of Medicine and the president of the Robert Benjamin Ablin Foundation for Cancer Research, writes, “The test’s popularity has led to a hugely expensive public health disaster.”
He goes on to write, “As Congress searches for ways to cut costs in our healthcare system, a significant savings could come from changing the way [prostate-specific antigen] is used to screen for prostate cancer.”
Ablin notes that the test “can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer.” But, although “the medical community is slowly turning against PSA screening,” drugmakers “continue peddling the tests and advocacy groups push ‘prostate cancer awareness.'”
Ablin urges the medical community to “confront reality and stop the inappropriate use of PSA screening.”
Although it may eventually come to this, I’m choosing to follow the American Cancer Society Guidelines that suggest I sit down, present my patients with their choices and the risks, benefits, and costs of each. I’m finding most are more than capable of making their own decision.
To explore two sides of this debate, read Benefits of PSA Test Are Exaggerated and PSA Cancer Screening, Much Like a Seat Belt, Is a Wise Choice for Men.
Also see my blog New guidelines say physicians should educate men on risks and benefits of PSA testing.