In April, a number of physician groups launched the Choosing Wisely campaign focusing on 45 tests and procedures that are overused during annual physicals. In fact, one of the overused tests is the PSA to test otherwise healthy men over 50 for prostate cancer.
At our last President's Clinical Quality Council, the issue was debated between a few of our primary care doc members and a urologist member of the Council. The primary care docs have embraced Choosing Wisely while the Urologist suggested that the change be used with caution. The delicate balance comes in with the necessity of the Choosing Wisely campaign versus the diagnosis of prostate cancer in healthy men.
The issue hit close to home recently when an extended family member of mine went for an annual physical, had a PSA and it was determined that he had prostate cancer. He had his prostate removed yesterday and all went well. The cancer was caught in time as a result of the PSA test.
The Choosing Wisely campaign is truly necessary to reduce the overuse of procedures and tests, but it has to be balanced with the patient in mind.