Why a decline in prostate cancer diagnosis might not be a good thing.

By: Mark DeGuenther, M.D.
with Urology Centers of Alabama
 

For a urology group, September is an important month. September is Prostate Cancer Awareness Month. Prostate cancer is the most common visceral cancer in men, with 1 in 7 men being affected in their lifetime. It is the second leading cause of cancer death in American men. Reports continue to show a decline in early prostate cancer diagnosis, but is this a good thing? There has been a steady decline in early diagnosis since 2011, when the U.S. Preventive Services Task Force recommended against routine PSA (prostate specific antigen) testing. Their recommendation, in my opinion, was based on both poor science (mainly a study period too short to show benefit from screening and data now suggests there is benefit) and the desire to save some money in the short term.

Why would a decline in diagnosis be a bad thing? Experts throughout the specialty are concerned that more men will develop fatal prostate cancer in the future. Nationally, more and more men are presenting with advanced and non-curable disease than at any time in the last 15 years. Presumably, these cases could have been caught earlier and treated effectively if the men had been screened. In addition to men losing their chance of being cured, treating advanced cancer is much more costly than curing it early.

At Urology Centers of Alabama, we have remained steadfast in our support and belief of PSA testing for men with greater than a 10-year life expectancy. Currently, there is an ongoing British trial looking into the benefits of PSA testing. Our hope is that the results of that trial will cause a rebound in appropriate PSA testing.