One of the most widely used screens for prostate cancer is the PSA test. I wrote about this last year, after several studies and a thorough review concluded that
“there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.” (USPSTF, Annals of Internal Medicine, 22 May 2012)Now, the Choosing Wisely campaign and the American Academy of Family Physicians (AAFP) have included not only PSA testing, but also digital rectal exams as procedures that are usually unnecessary. Their advice to physicians is very clear:
Don’t routinely screen for prostate cancer using a prostate-specific antigen (PSA) test or digital rectal exam.
It's not just prostate cancer screening that is wasteful and unncessary. After a review of the latest evidence, the AAFP, as part of the Choosing Wisely campaign, has identified 15 tests and procedures that most of us should just say "no" to.
Choosing Wisely, which was created by the American Board of Internal Medicine Foundation, is a great idea: a campaign to educate patients and physicians about what practices are:
- Supported by evidence
- Not duplicative of other tests or procedures already received
- Free from harm
- Truly necessary