Where’s the Outrage Over Prostate Cancer Screening?

May 31, 2012

Approximately 22,000 Coloradans will be diagnosed with cancer in 2012. Of that group, more than 3,000 are men who will be diagnosed with prostate cancer. Prostate cancer is the most commonly diagnosed cancer in Colorado today and has been so for the past five years. For many in our state, prostate cancer has impacted the life of a father, brother, husband or friend.

Last week, the U.S. Preventive Services Task Force (USPSTF) released its final recommendation against routine use of the Prostate Specific Antigen (PSA) blood test to diagnose prostate cancer. The government panel gave PSA screening a D rating – don’t recommend – for healthy men. This recommendation was given despite significant opposition from urologists, oncologists, patients and advocacy groups across the country. No urologists or medical oncologists who regularly treat prostate cancer participated in this particular recommendation.

There are often no early signs or symptoms of prostate cancer. By the time those symptoms manifest, the cancer has often metastasized and treatment options, as well as positive outcomes, are limited. Not all prostate cancer diagnoses are life threatening. Not all prostate cancer diagnoses require treatment. But, the PSA test remains the best option available today to help men assess their risk for prostate cancer and then determine the appropriate treatment with their physician.

The other concern with this recommendation is that the downgrade will also deny screening to those at the greatest risk for prostate cancer at this time— African-Americans and those with a family history of prostate cancer. African-American men are twice as likely to die of prostate cancer than Caucasian men. They are also already less likely to be screened for prostate cancer on a routine basis.

The largest study on prostate cancer screening, the European Randomized Study for the Screening of Prostate Cancer, published its updated findings in the March 2012 issue of the New England Journal of Medicine. This study demonstrated a 21 percent survival advantage to PSA screening for all patients, and furthermore, for those with the longest follow-up (over 10 years) this increased to 38 percent. This is consistent with experience in the U.S., where death rates from prostate cancer per 100,000 men have declined by nearly 40 percent over the last two decades. It is clear that through screening, we are detecting prostate cancer at earlier stages and saving more lives. Unfortunately, it appears that these data weren’t considered by the USPSTF when making its recent recommendation.

When the USPSTF came out with a recommendation against regular mammograms for women under 50 in November 2009, millions of women across the country immediately mobilized to express their outrage. Within weeks, the USPSTF had apologized for the way the recommendation was presented and backed off the original comments. It’s time for the men in our state and those across the country to do the same thing. The issue is choice. Discounting prostate cancer screening entirely will undo the significant progress we’ve made in diagnosing and treating this potentially devastating disease.

What role can Coloradans immediately play in reversing these recommendations? Pick up the phone, send an email or write a letter to our elected officials and express your concerns. Prostate cancer screening must not be restricted in this country. Thousands of Colorado lives will be at risk as a result.