JunkScience.com right again: No prostate test for healthy men

“Healthy men should no longer receive a P.S.A. blood test to screen for prostate cancer because the test does not save lives over all and often leads to more tests and treatments that needlessly cause pain, impotence and incontinence in many, a key government health panel has decided,” reports the New York Times. But JunkScience.com was all over this more than 13 years ago.

On July 16, 1998, we wrote:

The prostate cancer industry has started beating the drum for 1998’s Prostate Cancer Awareness Week, terrifying men into routine prostate cancer screening. Unfortunately, no study shows that routine prostate cancer screening saves lives. The only ones that definitely benefit from routine screening are the urologists and manufacturers of the prostate specific antigen (PSA) test.

We covered the controversy in more detail 12 years ago in PSA test: Promoting Stress and Anxiety?.

Click for the New York Times article.

8 thoughts on “JunkScience.com right again: No prostate test for healthy men”

  1. No competent doctor would order surgery or radiation based on a PSA alone. They probably would test for Free PSA. They then might order a biopsy and consider the Gleason Score. Based on this, they may recommend surgery or radiation or watchful waiting. IMHO, the PSA is a valuable but imperfect tool, just like many diagnostic procedures.

  2. There are many factors relevant to the ‘risk’ of a man developing prostate cancer: age, family history, genetics, vasectomy, and others that remain ‘buried’ in the unmined masses of medical data. To rely so heavily on the concentration of a specific protein (PSA, which is present in all men at all ages!) in the blood is simply myopic.

  3. Last year, my doctor and I talked about PSA. He made the interesting point that without a baseline associated with a position, the numbers mean very little. He’s seen numbers all over the place and in some men, the values change for reasons other than cancer. BUT, among men who have had prostate surgery with positive biopsies, PSA is a valuable diagnostic tool.

  4. Don, we are not debating whether or not a properly done test on a lucky man might save his life. That is obvious.

    The debate is whether it will save more lives than it will cost in unnecessary surgeries, chemotherapy, and radiation. That’s the bigger, more complex question.

  5. My PSA went up so they did a biopsy which found some fast growing cancer. Caught in time it is very treatable. Without the PSA test they would never have done the biopsy because the prostate felt normal.

  6. We know very little about the value of screening examinations. It required ten years and hundreds of thousands of mammograms in the 80’s, read by an expert mammographer, to find a 30% decrease in mortality from breast cancer, and that is still debated. We know colon cancer CAN be prevented not because of screening results but because we understand the path from benign polyps to cancer, remove the polyps and you do not get cancer. Also smokers have one if not two orders of magnitude greater incidnece of lung cancer. Prostate cancer? No one knows. There will always be anecdotal evidence both for and against screening but PSA has not been around long enough for us to know. If there is real data out there let me know.

  7. And just how is a man to know if his prostate is “healthy” without a PSA test? I was a healthy man until 2005 when my PSA level generated a biopsy for “precautionary measures”. 80% of the samples were positive for cancer, much to the shock of my Urologist. It’s now been over 6 years since my proton therapy at Loma Linda University Medical Center, and my annual PSA says I am once again “healthy”.

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