Panel advises against prostate cancer screening

Sep 2007
7,183
1,091
the state of confusion
WASHINGTON (AP) — No major medical group recommends routine PSA blood tests to check men for prostate cancer, and now a government panel is saying they do more harm than good and healthy men should no longer receive the tests as part of routine cancer screening.
The panel's guidelines had long advised men over 75 to forgo the tests and the new recommendation extends that do-not-screen advice to healthy men of all ages.


The task force analyzed all the previous research on this subject, including five major studies, to evaluate whether routine screening reduces deaths from prostate cancer. The conclusion: There's little if any mortality benefit.
But there is harm from routine screening: impotence, incontinence, infections, even death that can come from the biopsies, surgery and radiation, Moyer said

Panel advises against prostate cancer screening - Yahoo! News


hmmmm. all these years of being told to have a PSA and how early detction can save your life, and now we get this report.

makes me wonder if this is just a way to cut the costs on obamacare and to reduce the social security rolls.

we do have a resident medical expert on here,, MR Bourne what do you say about this?
 
Nov 2010
23,156
14,835
I think for years the PSA test effectiveness has been in question. This has nothing to do with cutting costs but the ineffectiveness of the study, which since it began was always controversial

The ultimate utility of the serum prostate specific antigen (PSA) assay as a screening test for reducing prostate cancer mortality has been an area of intense controversy since its introduction. PSA testing was not initially envisioned as a screening tool, but as a way to evaluate treatment responses in men with prostate cancer. Far in advance of evidence from randomized trials, the rapid and widespread uptake of PSA screening into US practice was initially driven by the intuitively logical assumption that the earlier one detects a malignancy, the more likely treatment is to be curative while minimizing associated harms. However, a growing body of observational evidence began to point to a substantial burden of associated overdiagnosis and overtreatment triggered by PSA testing. The interim results of several randomized clinical trials specifically designed to evaluate the impact of PSA testing on prostate cancer mortality have recently become available, but their incongruent results seem to have added fuel to the debate. This article presents a review of the literature on screening for prostate cancer with PSA testing; we include a detailed discussion of potential explanations for the contradictory results of the two largest randomized trials as well as reflections on the future of prostate cancer screening.
Screening for prostate cancer with... [Oncology (Williston Park). 2011] - PubMed - NCBI
 

NiteGuy

Former Staff
Jul 2011
17,044
13,694
Teardrop City
WASHINGTON (AP) — No major medical group recommends routine PSA blood tests to check men for prostate cancer, and now a government panel is saying they do more harm than good and healthy men should no longer receive the tests as part of routine cancer screening.
The panel's guidelines had long advised men over 75 to forgo the tests and the new recommendation extends that do-not-screen advice to healthy men of all ages.

The task force analyzed all the previous research on this subject, including five major studies, to evaluate whether routine screening reduces deaths from prostate cancer. The conclusion: There's little if any mortality benefit.
But there is harm from routine screening: impotence, incontinence, infections, even death that can come from the biopsies, surgery and radiation, Moyer said

Panel advises against prostate cancer screening - Yahoo! News

hmmmm. all these years of being told to have a PSA and how early detction can save your life, and now we get this report.

makes me wonder if this is just a way to cut the costs on obamacare and to reduce the social security rolls.

we do have a resident medical expert on here,, MR Bourne what do you say about this?
Well, I'm certainly no Bourne, but I do know a few things about the medical field.

There is no unanimous opinion in the medical community regarding the benefits of prostate cancer screening. Those who advocate regular screening believe that finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects. But, those side effects can be severe, as even your article says, ranging from permanent incontinence, permanent impotence, and the ever-popular death.

Those who recommend against regular screening note that because most prostate cancers grow very slowly, the side effects of treatment would likely outweigh any benefit that might be derived from detecting the cancer at a stage when it is unlikely to cause problems.

And the PSA test is far from a panacea. It's only an indicator for for any number of prostate / urethral / bladder problems, only one of which is prostate cancer. Definitive diagnosis can only come after that from a biopsy of the prostate, if an MRI or CT scan confirms a tumor. Even then, the biopsy alone can trigger some of those afore-mentioned side effects. On the other hand, one course of treatment, known as watchful waiting, is non-invasive, and can allow doctor to help determine how fast the tumor is growing, and then help you decide what course of action to take.

Why? Because most times, prostate cancer, even if detected at say age 50, is unlikely to affect the patient in a way that is fatal, even after 20 or 30 years. In fact, most men with prostate cancer are more likely to die from something else - heart attack, pancreatic or lung cancer, or plain 'ol old age, long before the prostate cancer would have become a serious mortality concern.

A recent randomized trial of prostate cancer screening with PSA, the European Randomized Study of Screening for Prostate Cancer (ERSPC), demonstrated only a modest 20 percent relative reduction in prostate cancer deaths among those screened when compared to those that were not at 9 years.

In this study, it was estimated that 1410 men would need to be screened and 48 men treated for prevention of one prostate cancer death over 10 years.
http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf

In other words, out of over 1,000 men screened, less than 50 were diagnosed with prostate cancer, and only one would have had a type of prostate cancer that is fast growing, likely to be fatal on it's own, and necessitating chemotherapy or radiation treatment, or surgery in an attempt to get rid of the cancer. And of all of the deaths determined to be from prostate cancer, between 2000 and 2004, the median age was 81.

Just something to think about. Especially when the likely outcomes for the more dramatic treatments mean you're going to spend the rest of your life without a sex life, or wearing adult diapers, or both. Personally, at that point I think I'd rather be dead anyway.
 
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Jan 2011
12,143
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east coast
I don't know how i feel about this. I know quite a few men that cancer was found because of the PSA, and their lives were saved. Most were well up in age, but also know young ones that were saved too. It is a slow growing cancer, and if i'm right, i think most of the time one will die of something else before prostate cancer, but still it can detect something going on. I think i prefer to still have the test.