A New York Times Magazine story published on the newspaper’s website on Wednesday details the complicated history of screening for prostate cancer in the U.S. and revisits the related story of the U.S. Preventive Services Task Force meeting that was abruptly cancelled for political reasons on November 1, 2010, the day before the midterm Congressional elections. I was interviewed several times for this story, starting shortly after my resignation from my position at the Agency for Healthcare Research and Quality, where for 4 years I had supported the USPSTF’s scientific activities on a wide range of topics.
I commend science journalists Shannon Brownlee and Jeanne Lenzer for their tireless reporting efforts and dogged persistence in pursuing the real reason for the meeting’s cancellation, despite repeated and vigorous denials of senior government officials. Former USPSTF Chairman Ned Calonge confirms in the Times story that politics played a role: “In November 2010, just before midterm elections, the task force was again set to review its [prostate screening] recommendation when Calonge canceled the meeting. He says that word leaked out that if the November meeting was held, it could jeopardize the task force’s financing.” It’s true that several members of Congress had threatened to cut off funding for the Task Force after it recommended against routine mammography for women in their 40s. To the best of my knowledge, however, the order to cancel the meeting came directly from the White House, not Congress. And according to my superiors at the time, Dr. Calonge had no choice in the matter. Read more »
We’ve seen it before. A couple of years ago, I wrote about Roswell Park’s Prostate Club for Men offering “Prizes For Prostates” — Buffalo Sabres hockey tickets or Buffalo Bills football tickets among other awards for men who showed proof that they talked to their doctor about prostate cancer.
They also promote this misleading statistic: “One in 6 men will be diagnosed with prostate cancer in their lifetime.” No explanation is given of what lifetime risk means. And no explanation is given of how many of these “cancers” are indolent and would never have harmed a man. Read more »
Dr. Otis Brawley has taken the gloves off on prostate cancer screening.
Brawley, chief medical officer of the American Cancer Society (ACS), makes some powerful statements about controversies in prostate cancer screening in a new YouTube video that is billed as the first of a series that the ACS will post on discussions with its officials.
Key nuggets from this video — not surprising to anyone who has followed this debate or Brawley’s past comments — include these quotes:
“I’m very concerned. There’s a lot of publicity out there – some of it by people who want to make money by recruiting patients – that oversimplifies this – that says that ‘prostate cancer screening clearly saves lives.’ That is a lie. We don’t know that for sure…
…We’re very concerned about a number of clinics that are offering mass screening where informed decision making – where a man gets told the truth about screening and is allowed without pressure to make a decision – that’s not happening. Many of these free screening things, by the way, are designed more to get patients for hospitals and clinics and doctors than they are to benefit the patients. That’s a huge ethical issue that needs to be addressed.
We’re not against prostate cancer screening. We’re against a man being duped and deceived into getting prostate cancer screening.”
Is the tide finally turning on PSA screening for prostate cancer? There’s no definitive data that PSA screening saves lives from prostate cancer, and it indeed can lead to further, invasive, tests that can cause men significant discomfort. Medical societies are divided on the issue. Primary care groups like the U.S. Preventive Services Task Force (USPSTF) recommend against it for older men, while the American Urological Association (AUA) continues to recommend screening.
In a strongly worded op-ed in the New York Times, Richard Ablin, also known as the founder of the PSA test, bemoans how our healthcare system has twisted its use. “The test’s popularity has led to a hugely expensive public health disaster,” he writes. Read more »
*This blog post was originally published at KevinMD.com*
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