PSA Test Part of Trend: Fewer Screenings for Well People - Sci-Tech Today

Many men were surprised last week when a government advisory panel recommended that doctors stop using the PSA test to screen healthy men for prostate cancer.

Yet experts say the recommendations by the U.S. Preventive Services Task Force are a part of a broader trend that has been building for years. People are taking a closer look not just at cancer screenings but at all medical interventions, says Steven Woloshin, co-director of the Center for Medicine and the Media at the Dartmouth Institute for Health Policy and Clinical Practice. Concern is growing because of doctors' recognition of their risks and side effects.

"There is something going on, not just in cancer," Woloshin says. "It's encouraging. It feels like this is the beginning of a sea change in attitudes toward testing, treating and overdiagnosis." Doctors are taking a "less is more" approach on several fronts: Last month, nine physicians' groups launched the "Choosing Wisely" campaign to discourage 45 overused tests and procedures, such as stress tests during routine annual exams. Many overused tests involve trying to "help the well stay well by looking for things to be wrong," says H. Gilbert Welch, a physician and co-author of Overdiagnosed: Making People Sick in the Pursuit of Health.

The American College of Radiology also is leading campaigns to reduce unnecessary exposure to medical radiation, which has been estimated to cause up to 29,000 cancers a year. Researchers estimate that one-third of CT scans may be unnecessary, according to a 2009 report in Archives in Internal Medicine.

And in the past four years, medical groups have voted to restrict several types of many cancer screenings.

In 2008, the task force recommended limiting the PSA screening to men under age 75, reasoning that older men probably would not be helped by a test that largely detects slow-growing cancers.

In 2009, the task force recommended against routine mammograms for women under 50. That recommendation drew fierce protests from many women, radiologists and many politicians.

In March, in a less controversial move, the American Cancer Society revised its recommendations for cervical cancer, suggesting that women get screened every three to five years instead of every year, a change that reflects the slow-growing nature of those tumors.

Last week, medical groups endorsed using CT scans to screen for lung cancer for the first time, but only in a very specific group: smokers and ex-smokers ages 55 to 74 who smoked the equivalent of a pack a day for 30 years and smoked within the past 15 years. (continued...)

1  |  2  |  Next Page >

 

© 2012 USA TODAY under contract with YellowBrix. All rights reserved.