The time-honored advice of urologists and many advocacy groups recommending that men have a PSA blood test annually to screen for cancer is under siege and has been strongly challenged in recent years by a number of medical experts and organizations.
When Dr. Jay Siwek, the vice chairman of family medicine at Georgetown University says that "blood tests can kill you," he is directly addressing the adverse fallout that is a real potential for some men who have been screened. Screenings can lead to biopsies and a false cancer misdiagnosis, which in turn leads to unnecessary surgery or other treatments that bring about adverse heath results for some men.
The number is far from insignificant. "There are many men who have had serious consequences from treatment," says Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society. "Those stories don't get told and they are not uncommon."
An independent group of scientists agrees with that assessment. Last Friday, a task force comprised of those researchers stated that routine annual PSA testing flatly brings about more harm than good for most men. Additionally, neither the U.S. government nor the American Cancer Society promotes the testing.
There are a number of misconceptions related to screening, such as the fallacy that it shows cancer (it merely measures inflammation, which can be high owing to diverse factors) and that it saves lives. A large American study found that annual screening does not lower a man's risk of dying from prostate cancer.
Siwek says that the fundamental issue with the test has always been its potential for raising false fears and bringing about unnecessary and sometimes harmful treatment.
"It's hard to stop the conveyor belt or the cascade effect that leads to more testing and treatment," he says.
Related Resource: USA Today, "Prostate testing's dark side: Men who were harmed" October 12, 2011
