Title: Prostate specific antigen (PSA) screening is not a useful tool in screening the general population for prostate cancer Author: Kevin M Piper MSIII Date: 01.06.2010 Key words: “Economic” and “Prostate Specific Antigen” Abstract: This project aims to educate the public about the lack of evidence to support screening the general population for prostate cancer by using blood tests. Simply looking at the financial cost of such screening, one can easily see the great expense in adding just one year to one person’s life. Further review would demonstrate such screening not only is very expensive, but many times causes more harm than good. In a time of great financial difficulty in the United States, it is crucial that the health care industry uses screening techniques that are proven to be cost effective (and improve health outcomes). This document was created by a medical student enrolled in the Primary Care Clerkship at the University of Minnesota Medical

School as part of the course project. The aim of the project is to present information on a medical topic in the format of a

patient education handout. It does not necessarily reflect the views of the University of Minnesota Medical School physicians and faculty. These materials are provided for informational

purposes only and are in no way intended to take the place of the advice and recommendations of your personal health care provider. The information provided may no longer be up to date since it has not been reviewed since the date of creation. The information provided should not be used to diagnose a health problem or

disease, or as a means of determining treatment. In the event of a medical emergency, immediately contact a doctor or call 911.

PROSTATE SCREENING: SHOULD DOCTORS TEST BLOOD FOR SIGNS OF PROSTATE CANCER?

WHAT IS THE PROSTATE? I. GLAND FOUND IN MEN

ONLY

II. SHAPED LIKE WALNUT

III. PRODUCES FLUID FOR SEMEN

IV. LOCATED IN ABDOMEN, JUST BELOW BLADDER

WHAT GOES WRONG IN PROSTATE CANCER?

1. PROSTATE GLAND CELLS GROW VERY QUICKLY : BECOME CANCEROUS

2. PROSTATE SIZE INCREASE GREATLY

3. OVERGROWTH BLOCKS URINE FLOW – THIS CAUSES PAIN WHEN MEN URINATE

4. CANCEROUS GROWTH CAN SPREAD TO REST OF BODY AND CAUSE DEATH

University of Minnesota Medical School

FAMILY MEDICINE ROTATION: FMCH 7600

KEVIN M PIPER MSIII

WHAT IS SCREENING?

• USING A LOW COST TEST TO FIND DISEASE IN THE BODY

• PROSTATE SCREENS:

* FEELING THE PROSTATE

* TESTING THE BLOOD – CALLED “PROSTATE SPEFIC ANTIGEN (PSA)”

COST OF SCREENING TEST & TREATMENTS: TESTS

1) PSA TEST (BLOOD) = $10

2) ULTRASOUND (PICTURE) = $85

3) BIOPSY (CUT OUT A SAMPLE PIECE) = $180

TREATMENT

1) PROSTATECTOMY (REMOVE PROSTATE) = $8,087

2) RADIOTHERAPY (LASER BEAM) = $3604

PROSTATE SCREENING: SHOULD DOCTORS TEST BLOOD FOR SIGNS OF PROSTATE CANCER?

WHAT WE KNOW RIGHT NOW: 1. COST TO SCREEN GENERAL

POPULATION = UP TO $28,000,000,000

2. COST TO EXTEND 1 LIFE FOR 1 EXTRA YEAR = UP TO $12,491 (50 YEAR OLD)

3. COST TO GIVE 1 PERSON 1 MORE “GOOD” YEAR = UP TO $42,000 (50 YEAR OLD)

WHAT TO TELL YOUR FAMILY AND FRIENDS: *** WE DO NOT KNOW ENOUGH ABOUT BLOOD SCREENING

• NO MASS SCREENING FOR OLDER MEN

• HIGH RISK MEN SHOULD TALK WITH SPECIALIST DOCTOR TO DECIDE IF THEY SHOULD USE BLOOD TEST (PSA)

* ** MORE STUDIES ABOUT PROSTATE BLOOD TESTS WILL BE COMPLETED IN COMING YEARS

• THEN, DOCTORS WILL DECIDE IF BLOOD TESTS SHOULD BE USED TO SCREEN THE PUBLIC FOR PROSTATE CANCER!

ADDITIONAL RESOURCES: http://www.cancer.gov/cancertopics/types/prostate http://www.webmd.com/prostate-cancer/default.htm http://www.mayoclinic.com/health/prostate-cancer/DS00043