Is Routine Screening For Prostate Cancer Necessary?


A government panel, the United States Preventive Services Task Force, said on Thursday that men 50 and over should no longer have routine P.S.A. screening for prostate cancer, based on the findings of five well-controlled clinical trial studies. The test, says the panel, does not save lives and has led to men taking more tests and undergoing treatments that have caused pain, impotence and incontinence in many.

Given that there are 44 million men over 50 in the US and that over 33 million have had the P.S.A. test (which measures a protein — prostate-specific antigen — released by prostate cells) the new recommendation could have wide repercussions for men’s health. Could it be possible that tens of thousands of men have undergone medical procedures that have done them more harm than good, and that doctors — urologists in particular — have been routinely prescribing treatments that have turned out to be unnecessary?

New Clinical Trials

The stakes are high. One in six men in the US will eventually be diagnosed with prostate cancer. An estimated 32,050 men died of the disease last year, with most deaths occurring after the age of 75; the disease is not common in men under the age of 50. However, autopsy studies reveal that a third of men aged 40 to 60 have prostate cancer, three-fourths after the age of 85.

The largest of the new clinical trials about prostate screening showed that “if any benefit does exist, it is very small after 10 years.”

The European trial had 182,000 men from seven countries who either got P.S.A. testing or did not. When measured across all of the men in the study, P.S.A. testing did not cut death rates in nine years of follow-up. But in men ages 55 to 69, there was a very slight improvement in mortality. The American trial, with 76,693 men, found that P.S.A. testing did not cut death rates after 10 years.

The rise in P.S.A. testing has led to a rise in biopsies and treatments, including some that have led to other health problems for many men:

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test, according to the task force. Among them, at least 5,000 died soon after surgery and 10,000 to 70,000 suffered serious complications. Half had persistent blood in their semen, and 200,000 to 300,000 suffered impotence, incontinence or both. As a result of these complications, the man who developed the test, Dr. Richard J. Ablin, has called its widespread use a “public health disaster.”


Uproar Expected

Two years ago, the same government task force caused an uproar when it recommended that women over 40 no longer needed to have routine mammograms. Mindful of the potential controversy, the panel delayed releasing the recommendation about prostate screening for two years, until the upcoming week. Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force, explained:

“Unfortunately, the evidence now shows that this test does not save men’s lives. This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime. We need to find one that does.”

Advocates for routine prostate cancer screening — including Major League Baseball Joe Torre, former New York City mayor Rudolph W. Giuliani and advocacy groups such as Us TOO — as well as urologists are preparing to fight the recommendation. The drug business will also be stepping into the fray, treatment for prostate cancer being a “lucrative business.” In addition, the task force’s recommendations could play a significant role in determining whether the P.S.A. test is fully covered by private health plans as envisioned under the health reform law and also under government federal health programs such as Medicare (though, currently, Medicare is required under law to pay for the test, no matter what the task force recommends.)

Would it be better to use the current test despite the findings of the government panel, until a better test is developed? Or has widespread screening for prostate cancer caused more problems than benefits?


Related Care2 Coverage

Canada Says Goodbye to Jack Layton

Coffee is Good, Soy Milk is Bad: Which Foods Are Really Healthy?

Dancing for Cancer Research [VIDEO]


Photo by Unlisted Sightings


Tom Edgar
Tom Edgar4 years ago

I am 86 yrs old. have had Prostate cancer for eight years, Gleason count of eight. It was recommended at the hospital I have a biopsy to confirm the status. DON'T DO IT.

On my Coach trip home it was only the intervention of a passenger, who was a nurse, (Ironically a Midwife) that helped me survive the trip. For a year I bled each time I urinated or ejaculated.
This procedure only PROVED I had the problem, did nothing to cure it.

My G P suggested I take the Budwig formula and this I have done sedulously for the past eight years and will continue doing. I have no means of verifying efficacy but, to date, I have no prostate problems nor symptoms. For those wishing to follow her regime she did suggest adding Champagne to the mixture. My finances do not run to such exotic drinks but as it is only fizzy wine I substituted Stone's Green Ginger Wine as ginger is another anti inflammatory, I also like ginger. I also do not use cottage cheese but Organic Yoghurt as a substitute
I'm still alive, not claiming to be super fit, but my two sons who, smoked, (I never did) are both dead.

Sheri P.
Sheri P6 years ago

I think screening for prostate cancer is necessary. My Dad was diagnosed and treated accordingly and for that I am grateful!

Shannon G.
Shannon G6 years ago

Any time you treat cancer there is a issue with side effects. This has to do with screening not treatment. Listen, if my father in law would have been screened earlier he would not have had to have all the treatment you speak about. There are hormone treatments for this type of cancer that work, the trick is to get diagnosed and treated early.

Robert O.
Robert O6 years ago

I believe that screening is necessary, but it's the course of treatment that may follow is where the trouble lies since some treatments are dangerous or may be ineffective depending on the patient, their physiology, the progression ofthe disease, etc.

Shannon G.
Shannon G6 years ago

There is absolutely no doubt in my mind that prostate cancer screening has caused more pain,more fear,more heartache and irreversible side-effects from unnecessary interventions,than any perceptible good.

Tell that to my father in law who DIED last year from prostate cancer. He may still be with us if he would have had a screening earlier.

Jane Barton
Jane Barton6 years ago

I guess screening for it is good if you can cure it. If not, why do it?

Past Member 6 years ago


In your post you sited: "The prostate gland has also been found to be a "magnet"for heavy metals and if these are not expelled regularly, prostate cancer is one result!I"

So when these heavy metals are "expelled" -- do they go into the partner's body (assuming no condoms are used)? I'm concerned about where the heavy metals end up when they are expelled and where else they might do harm -- and why no one is talking about this aspect as well.

Susan O.
Susan O6 years ago

Nah, prostate cancer screening isn't necessary. After all, the men say that breast cancer screening isn't necessary for women, right?

Turn about is fair play, dudes!

Lisa W.
Lisa W6 years ago

The real crime here is how we've allowed our medical industry, yes, industry to make us so fearful of the "C" word that we are willing to undergo maiming, cutting, burning, and chemical warfare within our bodies. We were created perfect. Cancer isn't something we "catch", it's our bodies way of waging war on all the toxins put into it by the filthy environment, the chemically treated foods, hormone induced meats, fake multi-colored goodies that line the inner aisles of grocery stores, toxic waste dumped into oceans poisoning our fish. Yet around every corner there's another salesman trying to con us into thinking they can make it what? Has anyone cured cancer? Cleaned up the environment? Made for healthier food? Detoxed our produce? Criminalized the way animals are force fed and shot up with growth hormones, then pumped full of antibotics? Blame ourselves for allowing this to happen. We need to stop buying into the lies and start demanding better of those whose salaries we pay to serve us. All they've been serving up thus far is BS.

Dave C.
David C6 years ago

hope we don't let politics get in the way of science again....oh and by the way are these conservative leaning politicians/people willing to ensure that tests are paid for for everyone, or will it just be for those who can afford??????