Most internet sites on prostate cancer disagree with expert panel's recommendations

Less than 20 percent of top-ranked health sites advise against screening for prostate cancer.
Less than 20 percent of top-ranked health sites advise against screening for prostate cancer.

Only 17% of top-ranked consumer health web sites advise against screening for prostate cancer, a recommendation made more than 2 years ago by the US Preventive Services Task Force (USPSTF), according to a study presented at the 2014 Clinical Congress of the American College of Surgeons in San Francisco, California.

In an Internet search for the phrase prostate cancer screening on three main US search engines, study researchers found that most sites appearing on the first results page recommended a patient-individualized approach to screening.

Prostate cancer is the most common cancer in men besides skin cancer, affecting 1 in 7 American men over their lifetime according to the American Cancer Society. Screening can detect prostate cancer early. Screening tests for this cancer are the prostate-specific antigen (PSA) blood test, a digital rectal examination, or both.

"The recommendation not to screen men for prostate cancer is controversial," said lead author Philip Zhao, MD, a urologist at The Arthur Smith Institute for Urology at North Shore–Long Island Jewish Health System, New Hyde Park, New York. He performed the research while a resident physician at Rutgers–Robert Wood Johnson Medical School, New Brunswick, New Jersey.

"Our study results suggest that two-thirds of the online community disagree with the USPSTF recommendation against prostate cancer screening," Zhao said.

An independent panel of medical experts, the USPSTF recommended in 2012 that men of all ages not get the PSA or other tests to screen for this cancer regardless of their risk factors for prostate cancer. The task force contended that the potential benefit of lives saved from screening for prostate cancer (which it estimated at one man in every 1,000 screened) does not outweigh the expected risks. Possible risks the USPSTF cited included false-positive PSA results, complications from biopsy of the prostate, or side effects of treating a cancer that often is slow growing and not fatal.

The USPSTF recommends a discussion between patient and physician about benefits and risks of prostate cancer screening if a patient requests screening but advises physicians to recommend against screening.

Many medical organizations disagree with the USPSTF guideline, Zhao said. Both the American Urological Association (AUA) and the American Cancer Society (ACS) state that men at average risk who are older than 55 years (AUA) or 50 years (ACS) who expect to live at least 10 more years should decide, in partnership with their physician, whether to be screened for prostate cancer.

The researchers found 29 distinct web sites, with seven sites common to all three search engines. They analyzed all 29 websites for type of site host, accuracy of content, and screening recommendations.

Only one site, a commercial source, presented incorrect information about prostate cancer screening according to Zhao.

Of the 29 web sites, five (17%) recommended against screening for prostate cancer and another five gave no recommendations. Most sites (66%) advocated that men make an informed decision about prostate cancer screening after discussing the individual risks and benefits with their health care provider.

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