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Psa Testing Recommendation Challenged By Local Professionals

By JEFFARAH GIBSON

Tribune Features Writer

A final recommendation by the US Preventative Services Task Force (USPTF), to stop routine prostate cancer exams is being challenged by some medical professionals in the Bahamas.

Use of the prostate specific antigen (PSA) exam, which looks for signs of prostate cancer, has been discouraged by the task force who issued a Grade D rating.

According to the Prostate Cancer Foundation's website: "The D rating applies to men of all ages but does not apply to the use of PSA testing for monitoring patients after a prostate cancer diagnosis or treatment."

The task force grades according to one of five classifications (A, B, C, D, I). A Grade D rate means the task force found "at least fair evidence that [the service] is ineffective or that harms outweigh benefits".

The USPSTF stated that there is little, if any, evidence that PSA testing saves lives and that too many men instead suffer from impotence, incontinence, heart attacks and occasionally death from treatment of tiny tumors that would never kill them.

Dr Robin Roberts, urology consultant, and member of the Cancer Society, has fought tirelessly for 20 years to encourage Bahamian men to get their routine PSA testing. He said acting on recommendations from the task force would take the Bahamas backward.

"The Task Force's final recommendation is a backward step for us in the Bahamas. It is a major threat to the advances in the healthy lifestyle behaviors that we in the Cancer Society of the Bahamas have tried to inculcate in our male population over the past 15 years. In America, they can take that step because they are a more advanced country than we are. But as for the Bahamas we have not reached the level of America," he said.

In the past Dr Roberts said the Cancer Society has held free prostate testing events. Since the first free screening event, Dr Roberts said the number of men taking the exams have increased significantly.

"The first event, we only had a handful of men taking the PSA test. Recently we have seen hundreds of them coming out to get tested. After all of the hard work we have put into getting them to take the test, we would hate to see all of that go down the drain," he told Tribune Health.

Despite the recommendations by the task force, urologist at PMH, Leonard Stephens, said discontinuing screening for prostate cancer is not a chance they are willing to take.

"We cannot not screen for prostate cancer especially given the high incidence of the disease in the Caribbean. We will still advocate for prostate exams especially in the black populations. It is important that we continue to educate men about the disease," he said.

The task force is an independent group of national experts in prevention and evidence-based medicine that works to improve the health of Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, or preventive medications.

Dr Stephens said he pays closer attention to a recommendations issued by the American Urological Association.

"One thing to bare in mind when it comes to this recommendation is that it is just one body in America saying this. It is not like the entire urological body is making this recommendation, it is not the American Urological Association saying that," he said.

The AUA has a membership of over 18,000 urologists worldwide.

"The American Urological Association (AUA) is outraged at the USPSTF's failure to amend its recommendations on prostate cancer testing to more adequately reflect the benefits of the prostate-specific antigen (PSA) test in the diagnosis of prostate cancer. It is inappropriate and irresponsible to issue a blanket statement against PSA testing, particularly for at-risk populations, such as African American men. Men who are in good health and have more than a 10-15 year life expectancy should have the choice to be tested and not discouraged from doing so", stated the AUA's response.

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