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After decades of use, a routine test used for diagnosing prostate cancer has come under fire after a government panel questioned its safety, causing a controversy among many oncologists, urologists, and others in the medical community as to what is best for the patient.
Diagnostic techniques for various forms of cancer can often be uncomfortable or time-consuming procedures that patients undergo reluctantly and sometimes skip altogether. When it comes to testing for prostate cancer, however, that has not been an issue since the discovery of the prostate-specific antigen, or PSA. The protein is produced by the prostate gland and can be tested for during routine blood tests. The protein is often found in higher levels in men with prostate tumors, thereby making it an important biomarker for the disease.
Or does it? That’s the question that was put forth by the United States Preventive Services Task Force (USPSTF), a panel of nonfederal experts in the prevention of disease. The USPSTF performs extensive scientific reviews of preventive healthcare services, including screening, counseling, and preventive medications. In October, after a rigorous evaluation of the evidence regarding PSA testing, the panel released a draft recommendation that states that “there is moderate certainty that the harms of PSA-based screening for prostate cancer outweigh the benefits,” and the panel “now recommends against PSA-based screening for prostate cancer in all age groups.”1
Because PSA testing has been a routine blood test used to screen thousands of patients over the last few decades, this recommendation has caused oncologists and urologists to take sides. On one side, some firmly believe that the test helps people and the recommendations change nothing. On the other side, others feel that the recommendations were based on sound science and that PSA testing should not be considered the gold standard in prostate cancer screening. Ultimately, patients have been caught in the middle, and new dialogues are taking place as they try to decide what is right for them.
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