Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Reaching the end of PSA screening

Kenneth Lin, MD
Conditions
July 24, 2012
Share
Tweet
Share

In the summer of 2007, then-U.S. Preventive Services Task Force member Russ Harris, MD, MPH approached me about taking on what he suggested would be a fairly quick and straightfoward project: summarizing the small amount of medical literature on the benefits and harms of the prostate-specific antigen (PSA) test that is commonly used to screen asymptomatic men for prostate cancer.

Little did I know that this research and its implications would dominate the next five years of my career. There would be some good moments (my published systematic review of the topic was honored as AHRQ’s Article of the Year award in 2009) as well as many bad ones (encapsulated in this series of posts that recount the reasons for my subsequent resignation from the Agency in 2010). This year, the USPSTF finally confirmed what had become clear to me and many other scholars of PSA screening: the test’s harms outweigh its benefits for the vast majority of men, and therefore it should not be recommended.

Although the Medicare program and private insurance plans continue to pay for the PSA test, there is reason to hope that the new recommendation will eventually change medical practice. Despite the backlash that greeted the USPSTF’s 2009 recommendation for individualized decision-making regarding mammography for women in their 40s, recent national data has demonstrated a 6 percent decline in screening rates in this age group – modest but notable evidence that more women are making thoughtful screening decisions that reflect their personal values and preferences.

Based on the USPSTF’s assessment, I now tell older male patients that the harms of the PSA test’s downstream consequences are very likely to outweigh any potential health benefits. Some still request the test, but such requests are becoming less common.

During the past five years, I have given countless lectures and participated in many public debates about PSA screening. I recently agreed to address the subject once more in October at a panel discussion sponsored by the Department of Health Policy and Management of the Johns Hopkins University Bloomberg School of Public Health (where I am an adjunct instructor). And I have decided that for me, that event will be the end of the line for public speaking about PSA screening, at least until there is more evidence to discuss. It’s time for me to move on, personally and professionally. Nonetheless, I hope that others will take up the essential task of communicating the flaws of this test to physicians and the public, so that someday we may reach the end of the line on PSA screening itself.

Kenneth Lin is a family physician who blogs at Common Sense Family Doctor.

Prev

Sick days: When our children show us the way

July 24, 2012 Kevin 0
…
Next

Eliminate the guilt in parenting

July 24, 2012 Kevin 2
…

Tagged as: Oncology/Hematology, Primary Care

Post navigation

< Previous Post
Sick days: When our children show us the way
Next Post >
Eliminate the guilt in parenting

ADVERTISEMENT

More by Kenneth Lin, MD

  • How to recruit more students into family medicine

    Kenneth Lin, MD
  • When should you prescribe statins for older adults?

    Kenneth Lin, MD
  • Clinical practice guidelines have problems, but they’re not broken

    Kenneth Lin, MD

More in Conditions

  • How community and buses saved my retirement

    Raymond Abbott
  • How changing your self-talk can transform your entire life

    Faust Ruggiero
  • Why your clinic waiting room may affect patient outcomes

    Ziya Altug, PT, DPT and Shirish Sachdeva, PT, DPT
  • The ethical crossroads of medicine and legislation

    M. Bennet Broner, PhD
  • When doctors breathe the same air: How medical professionals become environmental activists

    Stephen Gitonga
  • When doctors don’t talk: a silent failure in modern medicine

    Cesar Querimit, Jr.
  • Most Popular

  • Past Week

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • The backbone of health care is breaking

      Grace Yu, MD | Physician
    • Why transplant equity requires more than access

      Zamra Amjid, DHSc, MHA | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Litigation stress is real: Here’s how to navigate it

      MagMutual | Sponsored
    • A simple 10-10-10 tool to prevent burnout through mindfulness

      Annabelle Bailey | Education
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
    • How community and buses saved my retirement

      Raymond Abbott | Conditions
    • How changing your self-talk can transform your entire life

      Faust Ruggiero | Conditions
    • Why retail pharmacies could transform diversity in clinical trials [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Could antibiotics beat heart disease where statins failed?

      Larry Kaskel, MD | Conditions
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • The backbone of health care is breaking

      Grace Yu, MD | Physician
    • Why transplant equity requires more than access

      Zamra Amjid, DHSc, MHA | Policy
    • The ethical crossroads of medicine and legislation

      M. Bennet Broner, PhD | Conditions
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Litigation stress is real: Here’s how to navigate it

      MagMutual | Sponsored
    • A simple 10-10-10 tool to prevent burnout through mindfulness

      Annabelle Bailey | Education
    • The crushing bureaucracy that’s driving independent physicians to extinction

      Scott Tzorfas, MD | Physician
    • How community and buses saved my retirement

      Raymond Abbott | Conditions
    • How changing your self-talk can transform your entire life

      Faust Ruggiero | Conditions
    • Why retail pharmacies could transform diversity in clinical trials [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Reaching the end of PSA screening
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...