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Paulus - I agree with you completely about how health care should be, but never will be financed in the U.S. As an MD, I was so aware that men, especially "younger" men are looking for any reason to avoid confronting such a simple decision as getting a blood test that might lead to such uncomfortable procedures as a prostate biopsy, worse yet, such a terrible diagnosis as CA prostate. The USPSTF gives many men just what they need to avoid this issue, even men with a positive family history (read their summary). Follow this subject on Twitter if you don't believe me. The influence of this study's D recommendation is now today far more powerful than any future lack of insurance coverage and many men will suffer and die unnecessarily.
Sorry, the above should read that the men without PSA screening in the European study have both a 20% greater chance of dying of Ca prostate and a 40% greater chance of being alive with metastatic prostate cancer than the population of men with PSA screening. We do need a more specific screening test that correlates with higher grade earlier age onset Ca prostate to reduce the number of unneeded biopsies and unnecessary treatment. Such tests are being developed.
Hal, As a urologist with a large experience in diagnosing and treating CA prostate, I am appalled at these recommendations which once it translates into denial of reimbursement, will end PSA screening except in men who are already largely incurable, since early CA prostate has no symptoms. Early undiagnosed untreated higher grade CA prostate is not only a certain killer, but is guaranteed in many to produce a life ending saga of bone cancer, even paralysis. In the only valid long term large study (European) over now 11 years the PSA screened men have a 20% less chance of dying of CA prostate cancer, but sadly, a 40% greater chance of living out their remaining life with bone metastases, waiting to die.
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