Manipulating Medicare

Published — October 11, 2011 Updated — May 19, 2014 at 12:19 pm ET

Debate rages over cancer screening

A prostate cancer surgery at the University of Chicago Medical Center. University of Chicago Medical Center, Bruce Powell/AP

Controversial recommendations on prostate tests supported by new review


A government panel’s controversial recommendation that healthy men should no longer be routinely screened for prostate cancer is fueling a continuing debate over unnecessary Medicare spending for cancer screening — the subject of a recent iWatch News investigation.

Last week, draft guidelines of the U.S. Preventive Services Task Force advised men against routine prostate cancer screening using the prostate-specific antigen (PSA) test because the test often leads to more harm than good, with the potential for harm posed by aggressive treatment offsetting any gain.

The findings were strongly disputed by the American Urological Association, which called the task force recommendations a disservice to men. The urologists say the test saves lives and provides important information to men about their health. On Friday, however, the Annals of Internal Medicine published an outside panel’s review of evidence backing the task force recommendations.

The debate last week centered on the value of the PSA test, but the cost to government health plans — both for the test and subsequent treatment — lurks in the background. An iWatch News story reported that forty percent of Medicare spending on common cancer screening — including the PSA test — is likely unnecessary. Cancer screening tests are vastly overused in the United States, the investigation found, in part because doctors disregard scientific evidence out of ignorance, fear of malpractice suits, for financial gain, or in response to patient demand.

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