Skip the Screen

The Dogma in cancer care has always been that preventing cancer is better than treating it. So routine screening for the early detection of the disease makes a lot of sense.

But a government group says that logic doesn’t apply when it comes to the prostate-specific antigen (PSA) test for prostate cancer. Regular screening doesn’t always save lives once you account for the high rate of false-positive results, and it increases men’s risk of serious complications from biopsies and treatment of tumors that would never have killed them. So in new guidelines concluding that the harms of testing outweigh the benefits, the U.S. Preventive Services Task Force recommends that no men receive routine PSA screening at any age. The advice is based on a review of the research, including two large trials of the PSA test, which found no significant difference in survival rates between men who did and did not get screened, after 10 to 14 years of follow-up.

The idea of forgoing a cancer screen runs counter to everything patients and doctors have been taught about prevention, but the panel’s advice stems from the understanding that not all cancers need to be treated. That’s especially true of prostate tumors, which are generally slow-growing and often don’t require aggressive intervention: 25% of men test positive for prostate cancer, but only 3% will die of it. Meanwhile, PSA testing can lead to medical interventions that unnecessarily raise the risk of infection, impotence, incontinence and even death.

It may take a while for doctors to accept the new advice, and critics are concerned that halting PSA tests will lead to a rise in more-advanced disease, which is harder to treat. The task force stressed, however, that patients with a family history of prostate cancer or other risk factors may still ask their doctor whether the PSA test makes sense for them, even if it’s not part of their routine checkup.

MEDICAL EVOLUTION

Health advice is based on research, but medical knowledge keeps advancing. That’s why doctors’ recommendations in these areas have changed over the years:

[This article contains a table. Please see hardcopy of magazine.]

Sources: U.S. Preventive Services Task Force; Journal of Clinical Oncology; Federal Trade Commission

BREAST CANCER 22%

Estimated drop in breast-cancer risk in overweight women who lose 5% of their body weight. The benefit may be linked to hormone levels that fluctuate with weight

DIET

Pom, Not So Wonderful

If you’re a fan of Pom Wonderful pomegranate juice, you probably got suckered into drinking it at least in part by the company’s advertisements, which have claimed that the antioxidants in the crimson elixir can treat, prevent and reduce the risk of prostate cancer, heart disease and erectile dysfunction. That’s a lot–too much, in fact–for any drink to do. A federal judge has ruled that Pom Wonderful used deceptive marketing in touting the beverage’s benefits.

The judge’s decision upheld most of the challenges included in a Federal Trade Commission complaint filed against the company in 2010 and ordered Pom to stop making misleading claims about the product’s efficacy in fighting disease. The company says it will appeal parts of the decision.