Prostate Cancer and the USPTF

There is an ongoing debate about the use of PSA testing for Prostate Cancer. The USPTF continues to rate it as a D and that is essentially a useless procedure. Specifically they state:

The harms of screening include pain, fever, bleeding, infection, and transient urinary difficulties associated with prostate biopsy, psychological harm of false-positive test results, and overdiagnosis. Harms of treatment include erectile dysfunction, urinary incontinence, bowel dysfunction, and a small risk for premature death. Because of the current inability to reliably distinguish tumors that will remain indolent from those destined to be lethal, many men are being subjected to the harms of treatment for prostate cancer that will never become symptomatic.

It is recognized that certain PCas are highly aggressive and result in short term mortality. However it is still problematic as to how best to determine them although multiple genetic tests seem to hold out significant promise. Notwithstanding this progress the USPTF  offhandedly rejects the PSA for all because for some it may be uncomfortable. This Rawlsian approach to social interaction is typical of the left and their desired management of society. One wonders what the incompetently managed VA does with the tests.

As recently stated by a Urologist in Medscape:

My own feeling is that screening via PSA testing should continue to be an informed decision between doctor and patient. Patients should not have a PSA test without first being consulted and informed of the risks and benefits, and of some of the uncertainty. When a man is diagnosed with prostate cancer, even if he has a low-risk cancer, he must be prepared to have psychological difficulty accepting active surveillance.

Patient survival and patient choice should trump a few patients who select the procedure and are left feeling poorly.