Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Medicare should stop paying for prostate cancer screening in men over age 75

Kevin Pho, MD
KevinMD
July 3, 2011
238 Shares
Share
Tweet
Share

The following op-ed was published on June 1st, 2011 in the New York Times’ Room for Debate blog.

Medicare should stop paying for prostate cancer screening in men over the age of 75.

You may be surprised to hear that, especially coming from a primary care doctor. But evidence is mounting that screening for prostate cancer is not only ineffective in older men, but may actually be harmful.

The cornerstone of prostate cancer screening involves measuring the prostate specific antigen, or P.S.A., in the blood. But the test is notoriously inaccurate and cannot differentiate between prostate cancers that are dangerous and ones that aren’t. It’s a crucial distinction, since most American men diagnosed with prostate cancer won’t die from it.

Studies have been inconclusive about whether prostate cancer screening saves lives. What’s more certain are the harmful effects, including impotence and urinary incontinence, caused by unnecessary prostate procedures stemming from false positive P.S.A. tests. The U.S. Preventive Services Task Force updated their prostate cancer screening guidelines in 2008, and after careful deliberation of the evidence, recommended against screening older men.

But those guidelines continue to be ignored. This past March, the Journal of Clinical Oncology found that nearly a quarter of men aged 85 and older continued to receive P.S.A. screening tests.

Why is this?

One reason is that Medicare pays for annual prostate cancer screening in all men 50 years and older, with no upper age limit.

Another is that drug companies market aggressively, and profit from, the treatments born from prostate cancer screening, whether necessary or not. In fact, Richard J. Ablin, the immunobiologist who discovered P.S.A. in 1970, called P.S.A. screening a “hugely expensive public health disaster.”

Dr. Kenneth Lin, lead author of the U.S. Preventive Services Task Force’s prostate cancer screening guidelines, also blames the news media. In an email to me, he said “news shows invariably feature athletic septuagenarians on the golf range telling reporters that they don’t want some government panel taking their P.S.A. tests away. But most 75-year-old men are in much poorer health, and prostate cancer surgery has no survival benefits in men over age 65, much less 75.

About $3 billion annually is spent on P.S.A. testing alone, with a substantial portion paid for by Medicare. An upper age limit on prostate cancer screening not only would shave those costs, but more important, spare patients from the harms of unneeded prostate procedures.

Kevin Pho is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on Facebook, Twitter, and LinkedIn.

Prev

Medicine and the examples of unintended effects of technology

July 3, 2011 Kevin 4
…
Next

Not engaging in end of life discussions is grounds for malpractice

July 4, 2011 Kevin 11
…

Tagged as: Oncology/Hematology, Primary Care

Post navigation

< Previous Post
Medicine and the examples of unintended effects of technology
Next Post >
Not engaging in end of life discussions is grounds for malpractice

More by Kevin Pho, MD

  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD

More in KevinMD

  • Surgeon General’s warning: the dark side of social media on children’s mental health

    Kevin Pho, MD
  • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

    Kevin Pho, MD
  • Is FDA-approved Veozah a game-changer in menopause hot flash treatment?

    Kevin Pho, MD
  • Remembering Heather Armstrong: the tragic loss of the “Queen of Mommy Bloggers” sparks a global conversation on mental health

    Kevin Pho, MD
  • Celebrating 2 million downloads of The Podcast by KevinMD!

    Kevin Pho, MD
  • Tragedy strikes Monday Night Football as Buffalo Bills safety Damar Hamlin suffers cardiac arrest. Is commotio cordis to blame?

    Kevin Pho, MD
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nose-brain connection: The surprising link between allergies and mental health revealed

      Kara Wada, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

      Zahid Awan, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

      Marie Livesey, DO | Physician
    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 29 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Long COVID Cognitive, Depressive Symptoms Tied to Brain Inflammation Marker
  • 'Practice Changing' Trial on Activity Recs After Prolapse Surgery
  • What's With the Buzz Around NAD+ Injections?
  • Standing, Walking After Major Surgery Tied to Less Risk of Post-Op Complications
  • Tenapanor Improves Abdominal Symptoms in Patients With IBS-C

Meeting Coverage

  • Tenapanor Improves Abdominal Symptoms in Patients With IBS-C
  • Benefits Found for Hand OA Drug Treatments
  • MRI-Based Screening May Detect Prostate Cancer Earlier
  • New Model Aims to Study Intestinal Fibrosis in Crohn's Disease
  • Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers
  • Most Popular

  • Past Week

    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • Nose-brain connection: The surprising link between allergies and mental health revealed

      Kara Wada, MD | Conditions
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Medical errors and the power of apologies [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

      Zahid Awan, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • 7 ways to beat burnout: a guide for health care professionals to reduce stress and reclaim their passion

      Marie Livesey, DO | Physician
    • The unjust reality of racial disparities in pediatric kidney transplants

      Lien Morcate | Conditions
    • The pros and cons of taking a gap year during medical school

      Med School Insiders | Education, Sponsored

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Medicare should stop paying for prostate cancer screening in men over age 75
29 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...