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Prostate cancer screening and treatment decisions must act on evidence, not beliefs
Date:1/25/2012

th from prostate cancer, the number of men who would have to be treated and potentially suffer the consequences of treatment to achieve this prompted the Task Force to recommend against wide spread PSA testing for all men without symptoms of prostate cancer. according to Garnick.

In two studies from 2009, one conducted in Europe and the other in the US, healthy men in their 50s and 60s were randomly divided into two groups; one was periodically screened for prostate cancer using PSA testing or a digital rectal exam, or both. The other group was not offered routine testing, but received standard medical care as needed.

The European study showed that only the men who were tested and treated for prostate cancer had a 20 percent likelihood of dying from the disease, while neither study showed if the men who were tested and treated lived any longer than those who were not offered routine testing. Such a decrease in prostate cancer mortality was not found in the U.S. study.

In the European study, researchers then determined that in order to save one life from prostate cancer, approximately 1,400 men would have to undergo screening, which would result in 48 having to undergo treatment. The remaining 47 could suffer serious side effects, such as incontinence and impotence, as a result of radiation or surgery.

"The overall death rate from all causes was not statistically different in both the screened and unscreened groups," says Garnick. "Unfortunately, the mortality data collected over the past 25 years shows that the natural history of prostate cancer is not as straightforward as my colleagues and I once believed. Many cancers will never cause problems during the patient's lifetime, and hence do not need to be treated, at least immediately."

Results from a long-term Canadian study indicate that the death rate from the disease for men who elect active surveillance, or choosing to delay treatment after a PSA test led to the
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Contact: Jerry Berger
jberger@bidmc.harvard.edu
617-667-7308
Beth Israel Deaconess Medical Center
Source:Eurekalert

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