Advisory of stopping prostate test provokes controversy in U.S.

Debates in the medical field developed on Monday as a U.S. government panel recommended that men of all ages should stop getting prostate cancer blood screenings. The United States Preventive Services examined all the evidence and found little if any reduction in deaths from routine P.S.A. screening and suggested that the test does more harm than good to healthy men. The P.S.A. test for prostate cancer, a blood test to screen for a protein that may indicate cancer, has become widely used because it can help detect tiny tumors at a very early sta ge, when they are theoretically most treatable. Unfortunately, according to the task force, the vast majority of the results are false-positives: the men don’t actually have cancer. And most of those found to have cancerous cells would not suffer ill effects because their cancer is so slow-growing that it would not cut short their lives. Those with faster-growing cancers may also not be helped if the cancer is extremely aggressive. After the recommendation came out last week, many prostate cancer specialists have been pushing back. Urologist Dr. Mark DeGuenther said this recommendation is more about saving money than saving lives. He said death rates from prostate cancer have dropped 40 percent since men began getting screened at age 40 and he says it will save taxpayers and patients more money in the long run to diagnose and treat cancers earlier rather than wait and have to provide expensive care for advanced stage cancers. "We all agree that we've got to do a better job of figuring out who would benefit from P.S.A. screening," said Dr. Scott Eggener, a prostate cancer specialist at the University of Chicago. "But a blanket statement of just doing away with it altogether ... seems over-aggressive and irresponsible." Dr. Deepak Kapoor, chairman and chief executive of Integrated Medical Professionals, which includes the nation's largest urology practice, said "We will not allow patients to die, which is what will happen if this recommendation is accepted." That task force's recommendation isn't final - it's a draft open for public debate. And obviously the debate is already under way.