'Don't Blame the Test'
“There are misconceptions about prostate cancer screening,” Karen Knudsen, MBA, PhD, said in an interview with The ASCO Post about newly published cancer statistics, including an increased incidence of prostate cancer, particularly advanced-stage disease. Dr. Knudsen is Chief Executive Officer of the American Cancer Society (ACS) and the ACS Cancer Action Network.
“A PSA [prostate-specific antigen] test and a digital rectal exam, by definition, cause no harm. They are incredibly effective mechanisms to determine whether someone may be at risk for prostate cancer,” Dr. Knudsen noted.
“The important thing is the clinical decision-making downstream of [these methods], and somehow when there was overtreatment for prostate cancer, we blamed the wrong party. We blamed the test. If someone has a mastectomy that she shouldn’t have had downstream of a concerning mammogram, we don’t blame the mammogram. We would blame the clinical decision-making. So, how for prostate cancer we blame the test is an interesting historical story we will need to unwind.”
In the past few years, “the science has progressed to the point that we can, much more effectively than in the past, place men into risk categories: active surveillance vs you really should go for treatment now,” Dr. Knudsen continued. “It is so important for us to move with the science, but to place the concern where it accurately fits—the clinical decision-making, not the test.”
She concluded: “For there to be an informed choice, you have to be informed by something. We would argue that something is the test. Otherwise, what are you informed by?”
DISCLOSURE: Dr. Knudsen reported no conflicts of interest. She is employed by the American Cancer Society, which receives grants from private and corporate foundations.
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