The task force based its draft recommendations on an exhaustive review of the latest scientific evidence, which concluded that even for younger men, the risks appeared to outweigh the benefits for those who show no signs of the disease.
“The harms studies showed that significant numbers of men, on the order of 20 to 30 percent, have very significant harms,’’ said Virginia Moyer, a professor of pediatrics at Baylor College of Medicine who chairs the panel.
Its recommendations have a widespread impact, especially on what services Medicare and private insurers pay for. The group’s influence was enhanced by the new federal health care law, which will base some of its requirements for coverage on the group’s ratings.
Doctors, researchers, and policy makers are increasingly questioning whether many tests, drugs, and procedures are overused, unnecessarily driving up costs and exposing patients to the risks of unneeded treatment.
Prostate cancer strikes more than 218,000 US men each year. About 28,000 die of it, making it the most common cancer and second-leading cancer killer among men.
Although prostate cancer can be detected with a physical examination, PSA testing has become the most common way a diagnosis is made. The test measures a protein in the blood produced by prostate tissue and has significantly increased the number of prostate cancer cases being diagnosed at very early stages. But it has been a matter of intense debate whether that translates into a reduction in the death rate. Prostate cancer often grows so slowly that many men die from something else without knowing they had it.
Because it is not clear precisely what PSA level signals the presence of cancer, many men experience stressful false alarms that lead to unnecessary biopsies to make a definitive diagnosis, which can be painful and in rare cases can cause complications.
Even when the test picks up a real cancer, doctors are uncertain what, if anything, men should do about it. Many men simply are monitored closely. Others undergo surgery, radiation, and hormone treatments, which often leave them incontinent, impotent, or experiencing other complications.
