In 2008, the United States Preventive Services Task Force recommended that over 75 skip the routine PSA tests that have been an important diagnostic tool for decades. The reason for this recommendation? In older men, PSA scores can be high as a result of simply getting older or having an enlarged prostate. In addition, the Task Force decided that since most prostate cancers are extremely slow-growing and don’t cause significant harm (the standard expression is that most men die with prostate cancer, not of it), getting the test is a waste of time and resources. Or, it could cause men to pursue unnecessary treatments, including some that might cause impotence or incontinence.
My question is; ‘Why on earth would anyone not want to allow men to have as much information about their health as possible?’ Wouldn’t you at least want to have the option of knowing? The subtext behind the Task Force’s recommendations is essentially that older men are not smart enough to evaluate treatment options before signing up
for invasive treatments. Fortunately, the majority of older men and their doctors agree and have completely ignored the Task Force’s recommendations.
In studies of older men done before and after the new guidelines came out, the rate of testing hasn’t changed. One of the men who ignored the recommendations is billionaire investor Warren Buffett, 81, who was recently diagnosed with early stage prostate cancer after a routine PSA test. In an interview, Buffett said, “I discovered the cancer because my PSA level recently jumped beyond its normal elevation and a biopsy seemed warranted.” He’s going ahead with radiation treatment. Buffett and others feel that if it hadn’t been for the PSA test, his early stage cancer might have gone undetected until it was far less treatable.
The question on some people’s minds is whether Buffett was getting any special treatment because of who he is (and how much he’s worth). The answer is a clear; No. At least not right now. Currently, the PSA test is available to every man in every socio-economic class in the U.S. But if the Task Force’s recommendation is accepted by insurance carriers, there’s no question that they won’t cover the test unless the man already has severe symptoms. By then, it will be too late. That’s when the PSA- and the extra years of life it has been credited with saving-will be something only the wealthy can afford. Is that where we really want to go as a country?
