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Wednesday, March 10, 2010

PSA Inventor Supports Less Screening

In a fascinating op-ed today in the New York times, the inventor of the PSA test calls attention to its misuse and pleads for more reasoned application of this test. He notes how many men are being rendered impotent and incontinent for a very minimal risk reduction, if any.


Until physicians can be assured that they will not be sued for malpractice for not performing screening, however, this is unlikely to yield much change in the current practice. There was a case in Virginia several years ago in which a family physician was sued for not doing PSA screening, despite the fact that he followed professional society guidelines which suggest having a discussion with patients about whether screening is necessary. His patient, based on this discussion, decided not to have PSA screening, and was later found to have prostate cancer, and sued the physician. At the trial, another physician testified that the "standard of practice" in Virginia was to perform PSA screening without such a discussion with the patient, and the physician lost the malpractice suit.

So, until we have seen our first successful lawsuit against a physician for performing PSA screening (which seems unlikely because any damages could not be attributed directly to screening alone), I wonder whether the situation will change much.

1 comment:

Unknown said...

Wow, Haya. Thank you for the heads up on the great article. I did not know that the PSA test has 3.8% detection rate of prostate cancer. That is laughably low. It sounds like men over the age of 50 who are routinely screened are frequently subject to anguish, torture and unnecessary mutilation at a rate of 50 times per every one life saved from cancer. That sounds like an inexcusably high rate of collateral damage.