Good Question: Why Do We Wait To Do Medical Tests?

MINNEAPOLIS (WCCO) — On Tuesday, Ben Stiller told Howard Stern he’s healthy after being diagnosed with prostate cancer two years ago. He was 48 at the time.

Doctors discovered the disease by giving Stiller a blood test that’s not recommended for someone that young. So, why do we wait to do medical tests? Good Question.

The American Cancer Society recommends a PSA (prostate-specific antigen) test for men over age 50 with an average risk of prostate cancer. The U.S. Preventative Services Task Force recommends against its use for screening.

“With every test you do in medicine, you have to ask risks and benefits,” says Dr. Peter Sershon, a urologic surgeon at Metro Urology and United Hospital. “You have to say is the risk of screening outweighed by the benefits of it.”

Dr. Sershon says it seems obvious that if you catch prostate or breast cancer early and people have good survival, then you should screen for it.

He says the risks are two-fold. First, there are commonly false positives associated with the PSA test. Second, there’s a fear of over treating the cancer.

Prostate cancer is a disease that has a huge range of behaviors that go from horrible to relatively harmless. Treating them can cause incontinence and impotence.

“The big worry with prostate cancer is over screening for it,” says Dr. Sershon. “Are you can are you picking up cancers that don’t necessarily require evaluation and treatment?”

Last year, the American Cancer Society changed its recommendations for breast cancer screenings. The bumped up the recommended age for a first mammogram from 40 to 45 for average risk women. Experts pointed out too early screening could lead to radiation exposure, unnecessary tests, false positives and added stress.

“All of that is true, but that being said, it still does save lives in 40-49 year olds,” Dr. David Agus, a professor of medicine at the University of Southern California, told CBS This Morning at the time.

Dr. Sershon agrees with the American Cancer Society guidelines of routine screenings for prostate cancer at age 50 for men of average risk. He believes the U.S. Preventative Services Task Force will change its recommendation to be in favor of screenings in the near future. The research has advanced to the point where doctors can better determine whether a case of prostate cancer is high-risk or not, making overtreatment not as much as a problem.

“A man deserves to know if he has cancer,” he says.

More from Heather Brown

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