Debate Over Need for Prostate Cancer Screening Continues

Established long-term relationships between primary care physicians and patients is important when it comes to prostate cancer screenings and treatment, researchers say.

In 2012, the United States Preventive Services Task Force recommended against prostate-specific antigen screening (PSA) procedures.

However, researchers say the task force study is flawed. With some organizations cautioning against routine population screening and others recommending it, patients are caught in the middle of the debate.

"The only way to find the serious prostate cancer cases is to screen," said study author Chad Lagrange, MD. "If there's a diagnosis, then men should get a second opinion to decide whether it needs to be treated based on the guidelines and all clinical information available."

When reviewing 1700 patient questionnaires regarding PSA screenings, the current study revealed mixed results. Out of the 4 categories evaluated, just 9% of patients had each area discussed.

Seventeen percent of patients were told experts disagree on whether men should have PSA tests done, while 23% were told that certain types of prostate cancer have slow growth rates and do not need treatment.

Meanwhile, 25% of patients were told PSA tests aren’t completely accurate for diagnosing prostate cancer. Another 21% were told that treating some prostate cancers can give you serious side effects, like urinary incontinence and erectile dysfunction.

According to Dr. LaGrange, physicians should be focusing on the over-treatment of prostate cancer, as some cancers do not need treatment and should just be watched over time.

LaGrange also advises an open and honest relationship between patients and physicians, to ensure every option is being discussed.

"This speaks to the physician-patient relationship,” LaGrange said. “An open discussion is more likely with a provider with whom patients have a long-term relationship.”