Why does it matter if an inaccurate test has been used erroneously to tell millions of men that they had prostate cancer?
Dr. Richard Ablin:
Prostate cancer is an age-related disease. For instance, almost half of all men aged from 50 to 59 have prostate cancer. But the clinical fact is this: only 3% of all men diagnosed with prostate cancer die of it; 97% of men with prostate cancer die of another cause, such as old age. If you screen every man, using the very arbitrary measures of PSA, yes you’ll discover a lot of cancers, but the vast majority (97%) of those cancers will never harm those men. So in fact, the subsequent treatments, such as radical prostatectomy, will do those men unnecessary life-altering harms.
There is no such thing as 100% in health care. Every test and treatment has its own rate of exchange based on benefit versus risk of harm. In PSA testing, the harms greatly outweigh the any benefits. Another sobering reality is that there are no clinical data that show that men with prostate cancer who have surgery live longer than men who do not seek treatment. In my book I explain these conundrums and point out that instead of wasting billions of dollars on PSA tests, we need to use those precious resources to find a true prostate cancer-specific marker, and equally, if not more important, improved methods of treatment with substantially less side effects, even toward a possible cure, because currently there is no cure.
- The PSA Test - My Take
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- Prostate Cancer and the PSA Test