Navigation Links
Prostate Cancer Over-Diagnosed: Study
Date:8/31/2009

The result is over-treatment for many men, researchers say

MONDAY, Aug. 31 (HealthDay News) -- Mass screening for prostate cancer with a test for prostate-specific antigen (PSA) has led to mass over-diagnosis and over-treatment, a new study contends.

Since the PSA screening test came into use in 1986, federal government data show that the number of prostate cancer cases in the United States has risen substantially, said the report in the Aug. 31 online issue of the Journal of the National Cancer Institute.

Treatments for prostate cancer include surgery and radiation therapy, and possible side effects are incontinence and impotency.

"The ideal screening test would have no effect on the number of cases," said study co-author Dr. H. Gilbert Welch, a professor of medicine at the Dartmouth Medical School's Institute for Health Policy and Clinical Practice. "It would change the time in life that the cancers were diagnosed, but not the number. Instead, there has been a sustained change in the number of cases -- 1.3 million more that would not have been diagnosed previously."

The death rate from prostate cancer has fallen in the United States, but not necessarily because of mass screening, Welch contended. "There are a number of reasons why mortality might fall, but the most obvious is that we have better treatment," he said. "Even without early detection, I expect mortality would fall."

Results of a European study reported earlier this year indicated that "to save the life of one man, 50 must be over-diagnosed," he said.

Guidelines for screening for blood levels of PSA -- a protein produced by the prostate gland -- differ widely. The American Cancer Society says that a PSA test should be offered at age 50, accompanied by an explanation of the potential benefits and hazards. The American Urological Association recommends a first PSA test at age 40, with follow-ups depending not only on the test score but also on factors such as ethnicity.

"The recommendations on this are all over the map, and that's because it's a close call," Welch said. "Different people look at the numbers and come to different conclusions. There is the potential to help some people and hurt some people."

In his own medical practice, Welch said, "I try to stay away from this one. If someone asks me, I explain the risks and the benefits."

Given the unknowns, it's entirely appropriate for a man to decide on having a PSA test without advice from a physician, Welch said.

But Dr. Judd Moul, director of the Duke University Prostate Center, after reading the new study, said, "This is not going to change my mind on the issue of screening." Moul recommends an initial PSA test at age 40, with follow-up if necessary.

"We now do have the potential for over-detection, but we still have 30,000 men a year dying from prostate cancer, and the best way to prevent deaths from prostate cancer is still screening," Moul said.

Both Moul and Welch agree that the PSA test is decidedly imperfect because it can't distinguish between the majority of prostate cancers that grow so slowly that they are no danger to a man's life and the fast-growing minority that are potentially fatal and require decisive treatment.

"Right now we don't have that magic biomarker," Moul said. "So I think it is more important to try to reduce the number of deaths than to worry about over-detection."

"I wouldn't expect one to come soon," Welch said, referring to a specific test for virulent prostate cancer. "So we will continue to find a lot of it, and a lot of it that doesn't matter."

More information

Learn about prostate cancer from the U.S. National Cancer Institute.



SOURCES: H. Gilbert Welch, M.D., professor, medicine, Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Hanover, N.H.; Judd Moul, M.D., director, Duke Prostate Center, Durham, N.C.; Aug. 31, 2009, Journal of the National Cancer Institute, online


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Watchful waiting is a viable option for prostate cancer patients with low-risk tumors
2. Prostate Net Announces: Inaugural Fore! Informed Decisions Golf Outing
3. Prostate cancer: Racial disparity gap narrows, men diagnosed at younger age
4. Tennis Legend John McEnroe Tells Men to Get Serious About Prostate Cancer
5. Hormone therapy for prostate cancer patients with heart conditions linked to increased death risk
6. Hormone Therapy for Early Prostate Cancer Not Always Best
7. Hall of Fame Quarterback Takes Hit From Prostate Cancer, Urges Men to be Proactive About Their Own Prostate Health
8. Treating Prostate Cancer: Old School vs. New School
9. Prostate Net Announces: Major Medical Education Initiative for Patients, Caregivers and Healthcare Professionals
10. Prostate Cancer Kills - Every 20 Minutes; September Is Prostate Cancer Awareness Month
11. Obesity Tied to Prostate Cancer Recurrence
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Prostate Cancer Over-Diagnosed: Study
(Date:10/13/2017)... Fort Worth, TX (PRWEB) , ... October 13, ... ... and financial planning agency serving communities in the greater Dallas, Miami, and Raleigh ... a young boy fighting to overcome a rare and deadly chromosome abnormality. , ...
(Date:10/13/2017)... ... October 13, 2017 , ... While it’s often important to take certain ... inventor from Austin, Texas, has identified a solution. , She developed a prototype for ... lighting. As such, it eliminates the need to turn on a light when taking ...
(Date:10/13/2017)... Las Vegas, Nevada (PRWEB) , ... October 13, 2017 , ... ... of 7® Hemp CBD Oil utilizing Purzorb™ technology. Applying the Purzorb™process to full spectrum ... CBD dose required and providing a CBD form that can be easily incorporated into ...
(Date:10/13/2017)... Shelton, CT (PRWEB) , ... October 13, 2017 , ... ... and long-term care services, staged a mock evacuation of the facility as part of ... Department, Shelton Fire Department, Echo Hose EMS and Shelton City Emergency Manager, as well ...
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading network for ... for action towards gender equality at their inaugural Summit in New York City in ... reached a social audience of over 3 million. To watch the Mobilize Women video, ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... DIEGO , Oct. 12, 2017   Divoti USA ... Alert Jewelry up to the standard of the latest FDA requirements, ... June 2017). Anyone in need of Medical ID jewelry ... Medical Alert Jewelry are engraved in terms of the ... Divoti ...
(Date:10/11/2017)... Calif. , Oct. 11, 2017  BioPharmX Corporation ... scientific team that developed an innovative way to use ... of the delivery of new drugs. ... Fall Clinical Dermatology Conference will show how researchers from ... Hospital, Harvard Medical School used a suite of imaging ...
(Date:10/11/2017)... 2017  True Health, a leader in integrated ... during National Breast Cancer Awareness month to educate ... Research recently published ... more than 10 million American women are at ... or BRCA2 and have not had testing. These mutations ...
Breaking Medicine Technology: