This is an archived article that was published on sltrib.com in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

As a 14-year prostate cancer survivor and advocate, I am angered and saddened by the recent United States Preventive Services Task Force issuing a Grade D ("discourage the use of this service") for the use of the prostate specific antigen (PSA) test as a means of detecting prostate cancer.

I am angered because this decision seems to fly in the face of a great deal of data supporting the use of the PSA test as a means of early detection.

And I am saddened because, if general practitioners and insurance companies follow this advice, prostate cancer screening will revert to the "pre-PSA" days of the '80s when 75 percent or more of all prostate cancer diagnoses were already metastatic — a death sentence since there is no controlling the cancer when it has spread to the bone and soft organs.

A discussion of some past actions of the USPSTF is in order:

In 2009, the USPSTF issued a "Grade B" (offer or provide this service) for biennial screening mammography for women ages 50 to 74 years and a "Grade C" (an individual decision) for women under the age of 50. In contrast to the PSA screening decision above, this action was met with cries of protest from around the country including from the American Cancer Society and the Centers for Disease Control and Prevention as well as a great deal of media coverage.

Then, in October of 2011, USPSTF issued a draft PSA screening recommendation for a "Grade D" for all men and invited public comment. The response was so large the USPSTF website was "taken down." Unfortunately, the USPSTF issued the recommendation as final in May.

It appears that this last recommendation relied heavily on the now completed prostate, lung, colorectal and ovarian (PLCO) trials, which have, in the prostate portion of the trials, been largely discredited because some members of the control or non-screened group had received screening prior to the trial thereby "contaminating" the trial. Also, the study was terminated after seven years, a period that other studies showed was too short.

On the other hand, the Göteborg trial studied 20,000 men ages 50-64 with a contamination rate of only 3 percent compared to the PLCO rate of 40 percent.

The follow-up covered 77 percent of the patients for 14 years and the study showed a 40 percent mortality decrease in the patients undergoing screening. The Göteborg data also showed the inadequacy of ending the trial at seven years, probably because prostate cancer is a relatively slow-growing cancer.

Also ignored by the USPSTF, it appears, is the database of the Surveillance Epidemiology and End Results, which shows a 40 percent decrease in age-adjusted prostate cancer mortality from 1992 (PSA was approved by the FDA as a screening aid for diagnosis in 1994) to 2007.

Similarly, the European Randomized Study of Screening for Prostate Cancer showed 20 percent lower prostate cancer death rate among the screened patients. Applying circumstantial evidence, there are more prostate cancer cases each year than there are breast cancer cases, but prostate cancer deaths are fewer than breast cancer deaths. Does that mean PSA screening is more effective at preventing deaths than mammography screening?

This disparity between PSA testing and mammography shows up in federal research funding as well. The National Cancer Institute and the Congressionally Directed Medical Research Program both spend twice as much on breast cancer research as on prostate cancer research.

Men, it's high time to make our voices heard.

Kermit Heid is retired and is serving a third term as a member of the National Cancer Institute's Consumer Advocates for Research and Related Activities. He led the American Cancer Society Man to Man prostate cancer support group in Salt Lake City for four years and is an American Cancer Society Irwin Goodman Fellow and recipient of their 2002 Harmon J. Eyre Award. He is secretary/treasurer of Utah Cruisin' for a Cure Inc.