Without Screening, Higher Risk Prostate Cancer Is Increasing
In an earlier blog from only a few weeks ago, I commented on the fact that I’m seeing more and more patients come into my clinic with higher risk prostate cancer. And now there is a new study to support my observation. Dr. Timothy Schultheiss from the City of Hope Medical Center looked at 87,562 men with prostate cancer diagnosed from 2005 to 2013 by the National Oncology Data Alliance. He was the first investigator to show that beginning in October 2011, there was a steady rise in patients being detected with higher-risk prostate cancer. Why the change? Why were these men’s cancer not being detected sooner?
October 2011 is when the US Preventative Services Task Force (USPSTF) first recommended halting PSA testing in all men, at any age.
Two Key Facts
Dr. Schultheiss presented 2 Key Facts at the Genitourinary Cancer Symposium in Orlando in February 2014:
1) Starting in 2011, there has been a 3% increase every year in detecting men with intermediate or higher risk prostate cancer with “no evidence of a plateau.” This rise will continue.
2) The percentage of men age 75 or older who had a PSA greater than 10 ng/mL increased at a rate nearly double that of the overall population.
If You Don’t Screen for Prostate Cancer, the Horse May Be out of the Barn by the Time You Find It
I believe that the take-home message is that, as always, the US government agency (USPSTF) went too far in suggesting that no man should undergo PSA screening. I think that family history, other medical problems, and results from a routine digital rectal examination on a yearly basis need to be factored into the decision of who gets screened and who does not. For all patients, an open and informed discussion with your primary care physician just may save your life.