Prostate cancer and the PSA test: It's hard to understand risk
By Eryn Brown, Los Angeles Times / For the Booster Shots blog
4:19 PM PDT, May 21, 2012
The U.S. Preventive Services Task Force has released new guidelines for prostate cancer screening — urging doctors not to use the popular PSA test to detect the disease.
The new recommendations, which were published in the journal Annals of Internal Medicine on Monday, hardly mark the first time public health officials have called the value of the blood test into question. The first concern is that the test doesn't actually save lives. The second is that it might cause harm because it ferrets out slow-growing cases of prostate cancer as well as aggressive ones -- leading many men with harmless cases to get unnecessary treatment. Fighting prostate cancer can involve surgery or radiation, and can cause men distress, incontinence and sexual dysfunction, critics of overtreatment say.
But advice against screening can be difficult for physicians and patients to accept, said researchers who study how the public understands health risk.
Julie Downs, director of Carnegie Mellon University's Center for Risk Perception and Communication, said that patients often think of cancer the same way they think of infectious disease — as a toxin in the body that needs to be expunged, rather than cells gone awry that might best be left alone. Intuitively, it’s hard to regard cancer as a condition you’re more likely to die with than to die from.
(More here.)
The U.S. Preventive Services Task Force has released new guidelines for prostate cancer screening — urging doctors not to use the popular PSA test to detect the disease.
The new recommendations, which were published in the journal Annals of Internal Medicine on Monday, hardly mark the first time public health officials have called the value of the blood test into question. The first concern is that the test doesn't actually save lives. The second is that it might cause harm because it ferrets out slow-growing cases of prostate cancer as well as aggressive ones -- leading many men with harmless cases to get unnecessary treatment. Fighting prostate cancer can involve surgery or radiation, and can cause men distress, incontinence and sexual dysfunction, critics of overtreatment say.
But advice against screening can be difficult for physicians and patients to accept, said researchers who study how the public understands health risk.
Julie Downs, director of Carnegie Mellon University's Center for Risk Perception and Communication, said that patients often think of cancer the same way they think of infectious disease — as a toxin in the body that needs to be expunged, rather than cells gone awry that might best be left alone. Intuitively, it’s hard to regard cancer as a condition you’re more likely to die with than to die from.
(More here.)
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