That Pesky Prostate

A few days ago I sent in an SMS post about how testing for prostate cancer is often both futile and potentially dangerous.  I wondered why we test for prostate CA at all.  Today, the most respected group advisory group for preventive medicine in the country – the U.S. Preventive Services Task Force – officially recommended that men over the age of 75 not check for prostate cancer using the PSA or digital (read: El Finger) rectal exam.

For those aged 50-75, they take the same wimpy position that the American Academy of Pediatrics takes on circumcision, which is, loosely, “Well durn, if we’d a knowed we’d a said sowed.”  That is, they have no recommendation for or against testing in that age group.  Prior to 50, they recommend not checking unless there is a strong family history or other reason to worry.

Here’s an interesting (and confounding) factoid:  Thanks to the PSA test, the amount of prostate cancers detected has soared over the past 30 years.  The thinking is not that prostate cancer is suddenly rising, but that improved detection has led to much greater identification of the disease.  Sounds pretty good, right?  Modern medicine doing us right, right?  Well, it would be a good thing if we knew how to do anthing about prostate cancer.  The fact is that while the number of prostate cancers detected has risen dramatically, the number of deaths from the disease has remained exactly the same for the past 50 years.

So, prostate cancer detection is like identifying an incoming asteroid that will destroy the planet.  ‘Lotta good it will do you.

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