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    The return of prostate cancer: A step backward

     

    What surprised me most about this article was the sudden and vicious response by those groups advocating against the use of PSA. In an article from UPI, Otis Brawley, MD, chief medical officer of the American Cancer Society, said: "This study makes a dramatic claim about an issue all of us have been watching eagerly: namely, whether less PSA screening might lead to more advanced cancers. But the current analysis is far from adequate to answer that question sufficiently.

    "But this study, done by a group of urologists, didn't do that." Dr. Brawley added.

    He says the increase in advanced prostate cancer cases predates the 2012 U.S. Preventive Services Task Force recommendation of grade D for PSA, ignoring that the USPSTF has labeled it a “C” for years before that.

    Read: Midlife PSA levels strongly portend future deadly PCa

    Notice how Dr. Brawley added the phrase “done by a group of urologists”? Why is that important? Is he surprised that a group of physicians who have devoted their lives to men’s health, who are experts in diseases of the prostate, conducted research on prostate cancer? Or is he implying a bias in the research because of their background?

    The current chairwoman of the USPTSF is a general internist from the University of California, San Francisco. I assume Dr. Brawley would argue she shouldn’t do hypertension research for the same reasons. Unless he was being flippant about this topic. And if this is the case, maybe Dr. Brawley should leave sarcasm to us small-town bloggers and stick to science instead. My statements don’t affect public policy, whereas his statements can cause men to die.

    Or maybe Dr. Brawley should have listened to his own researchers. A recent paper published by researchers from the American Cancer Society, including Dr. Brawley, shows that the incidence of early-stage prostate cancer decreased by 6% between 2012 and 2013. Again, if you don’t look for early asymptomatic disease, you won’t find it.

    Have you seen: Is mpMRI ready for prostate Ca screening?

    Prostate cancer is returning. The first hints of this are starting to appear in the literature. More will come as the data mature over time. As urologists, we need to not only educate our patients and colleagues on the dangers of under-diagnosis, but we need to support groups such as the AUA, LUGPA, and AACU, who are lobbying Washington to change this ridiculous and neglectful policy concerning men’s health.

    If anyone else has experience with this situation or has an idea about how to best make our voices heard, please write me at [email protected] or sign in below to post a comment.

    More from Dr. Rosevear:

    My $4.07 check from an insurer: A sign of the Times

    The transgender community: Urology has a role and responsibility

    Marijuana and me: A Colorado urologist's experience

     

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.

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