MASSDEVICE ON CALL — Primary care docs surveyed by Johns Hopkins University researchers say they’re unlikely to curtail their use of a test to detect prostate cancer, despite recommendations from the U.S. Preventive Services Task Force.
The USPSTF stirred up a controversy last year when it suggested that routine prostate-specific antigen tests for healthy men might do more harm than good.
The task force reiterated its guidance last week, igniting a furious response from urologists and kudos from other quarters.
Now a small Johns Hopkins poll of 125 PC docs shows that although they agree with cutting back on screening for men over age 75 and for those not expected to live more than 10 years, most are not expecting to stop giving the test to younger, healthier patients.
Nearly 75% said their patients expect to receive PSA tests and 66% said it’s quicker to perform the test than to explain the reasons for discontinuing it. More than half said they fear exposure to malpractice lawsuits if they fail to order the tests.
"It can be very difficult for doctors to break down the belief that all cancer screening tests are invariably good for all people, all the time," study leader Dr. Craig Pollack said in prepared remarks. "Everyone agrees that PSA screening isn’t as good as we want it to be. If we had a test that was a slam dunk, it would be different. But now we know that for many men, the benefits may be small and the harms significant."
Clinical results seem to back the USPTF recommendations. Early results presented at the European Assn. of Urology this month from a long-term study of prostate cancer patients support the USPSTF’s decision, suggesting that surgical prostatectomy barely increased the likelihood for survival in patients with low-risk tumors.
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