Following finalization of the US Preventive Services Task Force Policy for prostate cancer screening which recommended against such screening, Dr. E. David Crawford & colleagues suggest that this approach may ultimately cost more due to having to treat greater number of patients with advanced disease.
Whilst adopting the USPSTF recommendation would initially save in the vicinity of $2.4 billion, the cost of treating men who will subsequently be diagnosed with 'clinically significant' prostate cancer would far exceed $2.4 billion.
Dr. Crawford also expressed concern that lack of screening would result in missing 0.57% to 1.22% of significant prostate cancer cases.
Dr. Crawford recommended that urologists should read the USPSTF report and give consideration to suggestions such as extending the amount of time in between screening individuals, using a better marker of disease progression and separating diagnosis from treatment.
Chicago urologist Anthony J. Schaeffer pointed out that it must be remembered that diagnosis does not necessarily have to lead to treatment and also that the ultimate decision as to whether or not to have a PSA test must be left to the patient, with his doctor providing him with sufficient knowledge to make such a decision.
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