Negative aspects of #screening for #prostatecancer may be acceptable, since screening halves mortality

Negative aspects of #screening for #prostatecancer may be acceptable, since screening halves mortality

This was the conclusion of a thesis presented at the University of Gothenburg and published in the journal The Lancet Oncology.

10.000 men aged 50-64 randomly assigned to either have a PSA test every 2 years or not to be screened.

The study showed that regular checks of PSA levels nearly halved the mortality from prostate cancer after 14 years.

The full report is in The Lancet Oncology.

The GNIF in Los Angeles recently said this:-

‘Failure to screen all men for prostate cancer will increase the morbidity and mortality of men as a result of undetected or late detection of their cancer.

Clearly, data indicates that screening has substantial benefits for patients who are aged 50-70 and men with increased risk such as African- American men and men with a family history of a first degree relative with prostate cancer.

Routine screening of ALL men may not be recommended, but at the very least there must be a recommendation for targeted screening of men according to risk’

The red sock campaigns view is that the option to have or not to have the PSA blood test should lie with the man and not the health-care professional.

For a man to make that decision he needs to be informed of the risks and the benefits of having the test.

Unfortunately the custodians of the information are those in primary care many of whom are reluctant to advise on the benefits and risks.

Secondly because prostate cancer has for the most part NO symptoms in the early stages a otherwise healthy man will not visit his primary care provider so how is he to know about his risk of prostate cancer.

Figures produced by the NHS Risk Management Team for prostate cancer produced a table that showed the presence of prostate cancer determined at autopsy.

Prostate cancer was detectable in 8% of the men aged 20-29

Prostate cancer was detectable in 28% of the men aged 30-39

Prostate cancer was detectable in 39% of the men aged 40-49

Prostate cancer was detectable in 53% of the men aged 50-59

Prostate cancer was detectable in 66% of the men aged 60-69

Prostate cancer was detectable in 80% of the men aged 70-79

Once again the red sock campaign view is that if it is detectable in men of all ages then we should use all available tests to detect the disease whilst it is at a stage where a cure is most likely.

The cost of caring for men with prostate cancer increases in the first two phases of the disease then finds a level during the containment period but then increases dramatically when the disease turns to bony metastatic.

Canadian figures showed  costs –

Phase I  – eqiv £728/100 days

Phase II  – eqiv £1848/100 days

Phase III  –  eqiv £840/100 days

Phase IV  –  eqiv £3136/100 days

Phase V  –  eqiv £8960/ 100 days

Whilst the costs have increased significantly since these figures were produced they clearly show the cost benefit of detecting and treating prostate cancer at an early stage.


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