Great in concept, with this article talking about the PSA in particular:
The prostate-specific antigen, or PSA, test is a simple blood test that can detect prostate tumors on average 11 years before a rectal exam does. To anyone who assumes that catching prostate cancer as early as possible leads to cures, the PSA test looks like a no-brainer.But the evidence doesn’t support that view. If early diagnosis of prostate cancer were really effective, then the mortality rate for the disease should go down as more and more men are screened. There has been a slight drop in the mortality rate in the United States in recent years, but screening may not deserve the credit. Mortality also has declined in Britain, where men are rarely given the PSA test.
I completely support the approach of shared-decision making between the patient and physician. However, I am skeptical that it will take off in our current malpractice climate. Go ask Daniel Merenstein.
Related posts:
- Shared decision making
- Evidence based medicine and shared decision making
- Giuliani, prostate cancer, and David Gratzer
- Is prostate cancer being overdiagnosed?
- 15 cancer screening posts you may have missed
- Prostate surgery
- Will patients accept the limitations of prostate cancer screening?
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Ditto that. One of my partners was sued in a very similar prostate cancer case…and lost. One local urologist and FP testified for the plaintiff, telling the jury that PSA testing was standard of care. My partner went into administrative medicine after that. I had seen the handwriting on the wall before and was ordering PSAs all the time. EBM will not sit next to you in the witness chair in court.
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