Joy Victory is deputy managing editor of HealthNewsReview.org. She tweets as @thejoyvictory.
[Editor’s note: Please see the comments section for a response from Roswell Park Cancer Institute and our reply.]
It’s hard to know what’s motivating the Roswell Park Cancer Institute in Buffalo, N.Y., to hold a prostate cancer screening event later this month, but we know what’s not motivating them: the evidence.
Their Sept. 24 sixth annual “Cruisin’ for a Cure” offers “complete, free prostate cancer screening for men at least 40 years old.” It’s one of many prostate cancer screening events being held this fall, all across the country, that flout what the evidence shows–which is that the potential harms of PSA screening outweigh the benefits–and that contradict recommendations from major doctor groups–which call for a full discussion of the pros and cons of screening before administering the test.
This Roswell Park event in particular caught our eye because, in the past, this institution has trotted out misinformation about prostate screening while offering prizes like free hockey tickets to men who joined their “Prostate Club.”
Despite getting called out for it (see link above), they’re doubling down on this misguided approach, this time with a car show event promoting a “cure” for prostate cancer. Far from offering any cure, however, the event seems to be about recruiting men for screening in ways that don’t conform with national recommendations.
Men with prostate cancer who receive treatment following a PSA screen way well believe themselves to be “cured” of a horrible disease. But as the evidence clearly shows, many healthy men who are screened also will undergo unnecessary, potentially harmful biopsies due to the test’s high false-positive rate. Others will be treated for cancers so slow-growing that they would never cause a problem during the man’s lifetime. Cancer treatments can expose these men to host of urinary and sexual side effects for no good reason.
‘These … screening events are discouraged by just about every professional organization’
“This [event] may be well intentioned (but ill informed) or it might be an attempt to increase revenue by finding more cancer cases,” said Doug Campos-Outcalt, MD, a contributor to our site who has served as a scientific analyst for the American Academy of Family Physicians and as the AAFP liaison to the United States Preventive Services Task Force (USPSTF).
“Regardless of the motive, these types of screening events are discouraged by just about every professional organization with a dog in the fight, including those that still see value in PSA testing,” he said.
What should happen, if not a screening event?
Instead, what might be more useful at these events is not actual screening, but opportunities for men to have discussions with clinicians to more fully learn the benefits and risks of screening.
“Everyone agrees that men should be well informed about the significant risks and unlikely benefit of being tested before obtaining the test,” Campos-Outcalt said.
Will men be told about those risks before being screened at the Cruisin for a Cure event? There’s no mention of potential risks or limitations of the test, or anything but pro-screening advocacy, on the website.
And while the site does reference the availability of “one on one education,” it’s difficult to imagine an informed discussion happening when men are already pre-registered for their “FREE Prostate Cancer Screening.”
Not just a man’s problem, either
In the months and years ahead, we very well may see similar dial back from physician groups when it comes to routine pelvic exams for women.
As the USPSTF announced this summer in a draft update to their guidelines, there’s simply not enough evidence on the table to support the use of routine pelvic exams in healthy, non-pregnant women–especially not without a patient-doctor discussion about the known and unknown pros and cons.
“The value of routine pelvic exams (not Pap smears) is questionable and for sure unproven,” Campos-Outcalt said.
But that’s not the message from Roswell Park, which tweeted last week promoting the upcoming screening–by unfortunately equating pelvic exams with PSA tests and implying that both help patients “take control of their health.”
“Women have been having Pap smears and pelvic exams for years,” the Tweet’s pull-quote says. “It’s time for men to also take control of their health by having a prostate exam and a PSA test.”
We’d argue it’s time to get up to speed with the evidence, instead.