The American Urological Association has done a complete — and unexpected reversal — on its recommendation for men when it comes to routine screening for prostate cancer.
In years past, the message was hammered hard: every male should have a PSA blood test every year beginning at age 40.
Other groups questioned this advice, saying that the test didn’t necessarily save lives, plus it was a test with too many false positives, so men would often undergo a lot of unnecessary, painful, and life altering tests and treatments.
Yet the urologists were pretty adamant, saying no: this screen for prostate cancer is a must.
But no longer. The group now says no screening before age 55. No screening after 70. And for those between 55-70 should really have a heart-to-heart with their doctors about whether this test should be done. Meaning, explaining the risk and benefits of testing.
It’s tough advice either way. For years I was a big believer in screening at age 45 for most men, and screening for all men at 50. Then I thought about what I would say to myself.
And the answer is: after starting my annual screens at age 45, I quit at 52. I saw too many men have a false test suggesting something was wrong. They had the heck scared out of them. They then underwent painful testing. Some were even treated with harsh surgery that left them incontinent or impotent for a small cancer that would have taken 50 years to kill them, if not longer.
Now I’m not saying prostate screening is a waste. It’s not. But it needs to be done on a selective basis. Have a family history? Maybe test. African-American? Maybe test.
Others – maybe test, maybe not. But at least explain that it’s not a perfect screen, and that it may lead to more problems than it’s worth.
But then again, for some, it still may be a lifesaver.
The key will be a test that defines that line more clearly.
In the meantime, we say “Ah, we’re just not sure.”