USPTF and Prostate Cancer

A while back the USPTF, despite the lack of clear evidence one way or the other, dictated as one would expect of an Government formed entity that PSA testing should be abandoned. Now in a JAMA Internal Medicine report they find little if any compliance. As is reported in Medscape:

The team analyzed data from the 2012 Behavioral Risk Factor Surveillance System, which is a joint initiative of the Centers for Disease Control and Prevention and the US states. They focused on data collected between January 2012 and February 2013, and identified male respondents aged 50 or more without a history of prostate cancer or prostate problem who reported undergoing prostate-specific antigen (PSA) testing within the preceding year. The researchers found that overall, 37.1% had been tested. But there was far more testing in older men compared with younger men. Nearly half of the older men in the survey had undergone PSA testing — 48.5% of men aged 70 to 74 years and 48.4% of men aged 65 to 69.

 Now in a NEJM article this past March the authors concluded:

Extended follow-up confirmed a substantial reduction in mortality after radical prostatectomy; the number needed to treat to prevent one death continued to decrease when the treatment was modified according to age at diagnosis and tumor risk. A large proportion of long-term survivors in the watchful-waiting group have not required any palliative treatment. 

Thus survival is a true benefit and physicians are acting rationally as are patients. Yet the USPTF  persists in its rationing and in my opinion unrealistic stance on this test. This is but one of the "benefits" I have previously discussed about the ACA.