PURE BUGGERY:

Cancer society casts more doubt on prostate tests (MIKE STOBBE, 3/04/10, AP)

Months after experts discounted the importance of routine mammograms and Pap smears for many women, the American Cancer Society is warning more explicitly than ever that regular testing for prostate cancer is of questionable value too, and can do men more harm than good.

The cancer society has not recommended routine screening for most men since the mid-1990s, and that is not changing. But the organization is urging doctors to talk frankly with their patients about the risks and limitations of the PSA blood test when offering it.

Two big studies last year suggested prostate cancer screening doesn't necessarily save lives, and any benefits can come at a high price. The widely used PSA test often spots cancers too slow-growing to be deadly. It can yield false-positive readings that result in unnecessary biopsies. And it can lead to treatments that can cause impotence and incontinence. [...]

The cancer society's new guidance released Wednesday urges doctors to:

• Discuss the pros and cons of testing with patients, offering written information or videos that discuss the likelihood of false test results and the side effects of treatment.

• Stop routinely giving the rectal exam because it has not clearly shown a benefit, though it can remain an option.

• Use past PSA readings to determine how often follow-up tests are needed and to guide conversations about treatment.

Cancer experts have been having second thoughts in recent years about the value of regular screening to detect certain types of cancer in its early stages. Last year, a government task force said most women don't need mammograms in their 40s, and a doctors group said most women in their 20s don't need annual Pap tests.

The big difference is that more men will follow the advice.

Posted by Orrin Judd at March 4, 2010 6:42 AM