Friday, August 19, 2016

USPSTF and What Happens Now?

The USPSTF or U.S. Preventive Services Task Force back in 2011 made the problematic determination based on what is in my and many others' professional opinions flawed data the recommendation that men no longer get PSA tests. The result? Apparently a massive drop in the detection of early stage prostate cancer. What does that mean? Has for some strange reason the incidence of PCa just stopped, slowed down, disappeared Or are we awaiting a time bomb of massive proportions of men having metastatic cancers. One need just read a 1950s version of Harrison or Cecil to see. Men will just show up with terminal bone mets.

Science Daily reports on a JAMA study:

From 2012 to 2013, the localized/regional-stage prostate cancer incidence rates per 100,000 men declined from 356.5 to 335.4 in men 50 to 74 and from 379.2 to 353.6 in men 75 and older, according to the study. The authors note the decrease from 2012 to 2013 was smaller than that from 2011 to 2012 (6 percent vs. 19 percent). Previously reported findings indicate PSA testing rates decreased significantly between 2010 and 2013. Other factors that could contribute to the decline in incidence rates for early stage prostate cancer include changes in the prevalence of unknown risk factors and preventive measures. "In conclusion, the decrease in early-stage prostate cancer incidence rates from 2011 to 2012 in men 50 years and older persisted through 2013 in SEER registries, albeit at a slower pace. Whether this pattern will lead to a future increase in the diagnosis of distant-stage disease and prostate cancer mortality requires long-term monitoring because of the slow-growing nature of this malignant neoplasm," the research letter concludes.

As the JAMA report concludes:

 In conclusion, the decrease in early-stage prostate cancer incidence rates from 2011 to 2012 in men 50 years and older persisted through 2013 in SEER registries, albeit at a slower pace. Whether this pattern will lead to a future increase in the diagnosis of distant-stage disease and prostate cancer mortality requires long-term monitoring because of the slow-growing nature of this malignant neoplasm.

I think we may already know the answer. As part of our "new" health care system we may very well be just letting the "old men die". Pity!