It’s not “as big a deal as you might think”

What isn’t as big a deal as we might think? According to The New York Times this morning, the US Preventive Services Task Force’s new recommendations about prostate cancer screening.

The actual article in the NYT (“The ABCs and Ds of whether to get prostate cancer screening“) was written by Dr. Aaron Carroll, a professor of pediatrics at Indiana University School of Medicine, and with all due respect to Dr. Carroll, we beg to differ. The change in these guidelines is a big deal to the prostate cancer advocacy community and to many patients who have been treated (or carefully monitored) for their prostate cancer.

It’s a big deal because the new guidance is largely correct whereas the prior (2012) guidance issued by the USPSTF was poorly thought through and therefore misguided. When that set of guidance was written, the USPSTF knew that new data was coming, and that active surveillance was already a good option for many men with low-risk forms of prostate cancer. All they needed to do was simply say that they weren’t going to change the then-extant guidance and that they would revisit it when the accumulating evidence had matured.

Changes to guidelines over time are, as Dr. Carroll observes, often a good thing … but not always. The changes implemented by the USPSTF in 2012 were not a good thing, and they were driven by data from two far too easily misunderstood studies (the PLCO trial and the PIVOT trial).

2 Responses

  1. It is a big deal. I had a single normal PSA test in the year 2000. My HMO did zero subsequent prostate testing or screening, much less any “active” surveillance. Thirteen years later I was in great pain with incurable metastatic prostate cancer and a PSA over 5,000. The huge certain medical costs, life altering side effects, and pain and suffering before my death will far exceed the nominal costs of PSA testing or screening that might well have saved my life.

  2. A blogging pediatrician with no expertise in prostate cancer would not be my choice of a resource. Very disappointed in the New York Times.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: