Reliable Sources allows more prostate screening crusading to flow through

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Media observer Howard Kurtz threw a big softball to his frequent guest Jeff Jarvis on his CNN “Reliable Sources” program last weekend when he had the author-blogger-prof come on to talk about his recent blogging about his prostate cancer.

Kurtz allowed Jarvis – unchallenged – to say “If just one person gets the PSA test that reveals this in me, that’s a good thing.”

Is it always a good thing? Can it be a bad thing? The U.S. Preventive Services Task Force reminds men that it can be. They state:

Potential harms from PSA screening include additional medical visits, adverse effects of prostate biopsies, anxiety, and overdiagnosis (the identification of prostate cancer that would never have caused symptoms in the patient’s lifetime, leading to unnecessary treatment and associated adverse effects). Much uncertainty surrounds which cases of prostate cancer require treatment and whether earlier detection leads to improvements in duration or quality of life.

It’s fine for Jarvis, Kurtz, Larry King, Michael Milken, Joe Torre, John McEnroe (the list goes on and on) to make whatever choice they choose to make and we hope they’re happy with it.

But it is wrong to use a network television platform to give one-sided advice to an entire population of men without giving balancing information on harms.

At the end of the segment, Kurtz told Jarvis, “You’ve broken a barrier.”

But Kurtz may have also been complicit in breaking journalism’s code of ethics (at least the Society of Professional Journalists’ code of ethics), which states that journalists should:

— Examine their own cultural values and avoid imposing those values on others.

— Support the open exchange of views, even views they find repugnant.

— Distinguish between advocacy and news reporting. Analysis and commentary should be labeled and not misrepresent fact or context.

If you value PSA screening in your own life, that’s fine. But with your network TV platform, support the important exchange of ideas on competing values, not just crusading advocacy.

It is not just a simple blood test. It is not a simple decision. Harms can occur. That should be reported.

(Thanks to Pia Christensen for the tip on this broadcast.)

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Lee Smith

August 26, 2009 at 9:34 am

With all the rhetoric from the U.S. Preventive Services Task Force (USPSTF) and thier ilk, I still fail to see how PSA testing can in ANY WAY be harmful. It’s the response to PSA testing that can be a problem so men need to be educated as to the odds, and when appropriate more data gathered for someone with prostate cancer to make best estimates of their future so that they and their MD’s can make informed decisions. PSA testing is a tool that has clearly lead, in some men, to a diagnosis of agressive prostate cancer — which cancer was then eliminated before it had a chance to leave the prostate. PSA testing is an indicator, uncertain and subject to error, but the best shot we have at this point. Sooner of later, I predict, the USPSTF will reclassify PSA testing, but even now lack of proof (or what they consider proof) is not disproof. The AUA and NCCN have detailed protocols for how to analyze PSA tests, how and when to follow up, etc. NONE of this was done in the so called, and clearly flawed, recent mass studies which could not “prove” the value of PSA testing, but really only served to prove the inadequacy of the studies given the many flaws (generally not featured in so called journalism).