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Prostate cancer treatment falls as PSA test becomes less common

The prostate-specific antigen test has generally been the standard way for doctors in Oregon and around the country to identify the signs of prostate cancer in older men, but the medical community has started to distance itself from the controversial procedure as questions about its reliability have grown more persistent. Critics of the test point out that it routinely identifies potential cancer in men who are later found to be cancer-free, and they say that this can lead to unnecessary and often debilitating treatment.

A professor from the University of Maryland wanted to know how views of PSA screening had impacted prostate cancer treatment in the United States, and he studied the medical records of more than 67,000 Medicare patients who had been diagnosed with the disease between 2007 and 2012 to find out. The professor discovered that the number of men undergoing prostate cancer treatment fell from 4.3 per 100,000 in 2007 to 2.5 per 100,000 in 2012. The research was published in January 2017 in the medical journal Health Affairs.

Population-based statistical analysis was used to reflect changes in ways that prostate cancer is both diagnosed and treated, and the data suggests that doctors are backing away from treating the disease for a number of reasons. Prostate cancer develops slowly, and treatment may be harmful rather than beneficial to men diagnosed in their late 60s or 70s. The U.S. Preventive Services Task Force recommended that men aged 75 or older not bother with PSA screening in 2008, but the independent group of physicians had changed its position by 2011 and advised all men to avoid the questionable blood test.

Medical malpractice lawsuits are often filed after a delayed diagnosis, but patients may also choose to pursue civil remedies when their doctors have ordered unnecessary tests or treatments. Physicians sometimes do this because they fear being sued by unhappy patients, and plaintiffs attorneys may call upon medical experts to determine whether or not testing was appropriate and treatment necessary.

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