Men 75 and older shouldn’t be screened for prostate cancer because the risks associated with screening and the stress of false alarms outweigh the benefits of detecting the disease.
Those were the conclusions announced yesterday by the U.S. Preventive Services Task Force, an independent panel of experts convened by the feds to establish guidelines for screening tests and other kinds of preventive medicine.
Prostate cancer is very common, but the disease often progresses so slowly that men, especially older ones, die of other causes before the cancer causes any problems. So screening, usually with a test called PSA, for the disease means you wind up giving surgery and radiation to some men whose cancers would have been fine if left alone.
“People say, ‘What’s the harm in screening?’ ” Howard Parnes of the National Cancer Institute told the Washington Post. “In fact, there are several ways in which screening can actually be harmful,” he said.
The challenge is balancing the harm associated with cancer treatments — which can include incontinence, impotence and, in rare cases, death — against the benefits of preventing the spread of aggressive forms of the disease, which is the second leading cause of cancer death in men.
The guidelines apply only to screening for men who show no signs of the disease, and don’t apply to treatment for men who go to the doctor with potential symptoms, such as painful urination or blood in the urine or semen, the New York Times notes.
Some doctors rejected the recommendation, saying it smacked of ageism and cost control by insurers. “It sounds like a regulation promulgated by an HMO” to save money, Dudley Danoff, a Los Angeles urologist told the L.A. Times. “I don’t think it is fair to a guy who is 75. Yesterday’s 75 is not the 75 of the 1950s.”
Update: For more on the risks and benefits of screening for younger as well as older men, see this Health Blog post.
Image of prostate cancer cells via Wikimedia Commons
Tidak ada komentar:
Posting Komentar