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It is reported the randomized trials used by the USPSTF do, in fact, show a benefit to patients. The Prostate, Lung, Colorectal and Ovarian (PLCO) Trial, while tainted by the prescreening contamination of the control arm, nonetheless showed that, for a group of young men with no co-morbidities, there was a significant reduction of prostate cancer death rates after a median follow-up of seven years (JCO2011:29:355-361). “Even more troubling,” said Hill, “is that while African-American men are disproportionately impacted by increased incidence and death from prostate cancer, this high risk group was under-represented in the PLCO study.” This may be the major deficit in the information considered according to Hill. “Failure to include an adequate sample of African-American men in this study speaks volumes about the efficacy of the conclusions drawn,” Hill said, adding, “The USPSTF's one-size fits all approach throws the baby out with the bathwater.”
Hill notes that the Hampton Roads Prostate Health Forum agrees with Thomas Farrington, president and founder of the Prostate Health Education Network (PHEN), the American Urological Association (AUA), the American Association of Clinical Urologists (AACU), the Large Urology Group Practice Association (LUGPA), and other reputable organizations and knowledgeable experts, that the USPSTF influence could be better placed.
“Rather than instruct primary care physicians to discourage men from having a PSA test,” Hill said, “the Task Force should instead focus on how best to educate these physicians on targeted screening and how best to counsel patients about their prostate cancer risk, especially men at the highest risk for the disease, such as African-Americans and those with a family history.”
Hill added, “The HRPHF agrees with Tom Farrington that the USPSTF has essentially issued a "death sentence‟ to those men who will need early detection of aggressive prostate cancer, but will ignore their prostate health based on this grievously-flawed recommendation. Even more tragic,” he added, “is the likelihood that their primary care physicians, if they have one, will do the same.”
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