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Panel: Don't Get PSA Prostate Cancer Screen

Harm Outweighs Benefit of Routine Prostate Cancer Screening, Task Force Says

PSA Test: What Men Should Do

While the USPSTF recommends against routine PSA testing, it doesn't say that men should never opt for it.

The American Cancer Society likely will keep its recommendation that a man not get a PSA test until he has discussed the harms as well as the benefits with his doctor.

Many members of the American Urological Association feel strongly that men should seek the test. But the official AUA recommendation is very close to that of the American Cancer Society: They say men should discuss the benefits as well as the harms with their doctors.

The USPSTF recommendation raises the question of why so many U.S. men get PSA tests -- and why they are likely to continue doing so despite the new advice. Otis Brawley, MD, chief science officer at the American Cancer Society, suggests an answer in an editorial accompanying the USPSTF recommendation.

"Americans have been taught for decades to fear all cancer and that the best way to deal with cancer is to find it early and treat it aggressively," Brawley writes. "As a result, many have a blind faith in early detection of cancer and subsequent aggressive medical intervention whenever cancer is found. There is little appreciation of the harms that screening and medical interventions can cause."

Brawley makes a distinction between PSA tests given to men who fully understand both the harms and benefits and mass screenings "commonly conducted in shopping malls, churches, and community centers; at conventions and state fairs; and even in vans parked in grocery store parking lots."

And he notes that prostate screening is a lucrative business. The screening may be given away for free -- but biopsies and prostate cancer treatments reap profits for hospitals and clinics.

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