Cancer Screening
A new study in the journal Frontiers in Cancer Epidemiology and Prevention found that the number of Americans seeking cancer screening has declined over the past decade. This includes such tests as mammograms for breast cancer, Pap tests for cervical cancer, sigmoidoscopy and colonoscopy for colon and rectal cancers, and prostate-specific antigen blood tests for prostate cancer. Unfortunately, the authors didn’t realize how important a factor confusion was and how it has tainted their study. The constant moving targets of both the validity and the timing of such screenings is driving everyone up a wall. Mammogram timing may change. Pap tests are being delayed. PSA testing is still problematic. Add to this a confused and indifferent public and you are going to get lower numbers of them participating. How do we fix this? Easy. Penalize the doctors if their patients aren’t screened on time. Coming to a primary care office near you!
“A RECENT STUDY SHOWS…” PSA tests are not acceptable as screening tests for prostate cancer (but you all knew that of course).
Just this morning I had to explain that to a patient who asked if I could just “order that blood test” when he saw me reaching for a glove. Unfortunately, our own marketing and operations VP sells the PSA as part of a corporate comprehensive “Wellness” package, because “that is what the companies want”. They DO NOT want their employees to have prostate / rectal (or hemoccult) exams. Hopefully, their PCP will be providing those services when we make available the results of our ancillary studies and physical exam.
…and then artificially command enalrging numbers of false postives, to send to the new legions of subspecialist breast surgeons, GYN’s, urologists, and radiation oncologists who will be doubtless jumping into their fields with no thought to the impending rate cuts and increasing overhead from our dear D.C. masters.