PSA screening not recommended for UK men

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NEIrish
Regular Member


Date Joined Aug 2010
Total Posts : 245
   Posted 12/7/2010 8:53 AM (GMT -6)   

Just putting this out there:

The United Kingdom's National Screening Committee has recommended against routine screening for prostate cancer risk with prostate specific antigen (PSA) testing.

The U.K. screening committee concluded that the PSA test's potential harms -- including worry and anxiety due to the reported high number of false positives -- outweigh any potential benefits.

The panel noted that benign enlargement of the prostate or a urinary infection can also lead to elevated serum PSA levels.

Still, the committee recommended giving a PSA test to any patient who requests one.

"The 'informed choice' program should ensure men receive clear and balanced information about the advantages and disadvantages of the PSA test and treatment for prostate cancer," the committee wrote in its review documents.

The screening committee's findings were based on evidence from three clinical trials -- the European Randomized Study on Screening for Prostate Cancer (ERSPC), the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO), and the Prostate Testing for Cancer and Treatment Trial (ProtecT).

The U.K. panel began its review in March 2009, after a new analysis from the ERSPC found a 20% mortality benefit from prostate cancer screening (albeit with a "great deal of 'over diagnosis,' " the committee noted).

Subsequent models by the School of Health and Related Research in Sheffield, England, found that a single screen at age 50 has little effect on age-specific incidence of prostate cancer, and found little benefit for annual or biannual screens.

The committee's main conclusions included the determination that PSA is "a poor test for prostate cancer and a more specific and sensitive test is needed," and that the test is "unable to correctly identify those cancers which will progress and those which ... may be safely watched."

The panel also emphasized that data related to incidence, prevalence, and treatments are poor and "renders planning very difficult."

The policy will be reviewed again in three years unless there is "significant new peer-reviewed evidence," the committee added.


clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2680
   Posted 12/7/2010 8:58 PM (GMT -6)   
Channel 7 (ABC affiliate) in Chicago has been teasing this story all evening as one of their lead stories on tonight's 10 o'clock news.  "What country has decided against a popular blood test for men?  Find out on tonight's 10 o'clock news!"  That's not an exact quote, but close.  One thing's certain.  They won't be able to provide a balanced analysis of the merits of the UK's position in the 20 seconds or so they'll alot to the story.
 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 12/7/2010 9:15 PM (GMT -6)   
Talk about burying your head in the sand, sounds like some brilliant thinking there - not.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 12/7/2010 9:41 PM (GMT -6)   
Sounds more like a cost control ploy than anything else..

"Still, the committee recommended giving a PSA test to any patient who requests one."

Educated and informed men, those who know what a PSA test is and what it does, can request one..Those less informed just had their fate cast to the wind with the official "ignorance is bliss" attitude...

To me, when translated, this announcement reads: Lets just wait until they develop symptoms of prostate cancer, at which point surgery and radiation are no longer an option, then we can put them on HT and call it a day..."
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 12/7/2010 11:23 PM (GMT -6)   
Either I misunderstood the reporting on ABC7 in Chicago at 10 p.m. tonight, or the station over-hyped the report, or the writers of the report are ignorant.  I'm offended with the implication in the report that only 1 in 48 persons who take the PSA test benefit from it.  The continual testing by my physician identified my cancer and its removal will, I believe, allow me to live a healthier and happier in years to come.  As the old saying goes, the 'devil is in the details.'  Without reading the fine print of any report and the entire report - it's meaningless to consider it seriously.

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 12/8/2010 12:21 AM (GMT -6)   
Mavica said...
Either I misunderstood the reporting on ABC7 in Chicago at 10 p.m. tonight, or the station over-hyped the report, or the writers of the report are ignorant.  I'm offended with the implication in the report that only 1 in 48 persons who take the PSA test benefit from it.  The continual testing by my physician identified my cancer and its removal will, I believe, allow me to live a healthier and happier in years to come.  As the old saying goes, the 'devil is in the details.'  Without reading the fine print of any report and the entire report - it's meaningless to consider it seriously.
I have to say that I did not see this ABC7 news report.  But, I am familiar with the details in the relevant statistics.  Only 1 in 48 men treated for prostate cancer would have otherwise died from it.  There is no question that the other 47 do indeed have PC...it's more a question of whether they really needed the treatment which they sought (since their cancer would not lead to their death). 
 
Of course, we don't have the 100% guaranteed, precise method of separating the few aggressive PC cases from the many indolent and slow growing PC cases, and many men are uncomfortable with anything less than 100% guarantee.  This is why we have an overtreatment epidemic today.  [Of course, there is nowhere in any medical field where one gets 100% guarantee, but for many men that is besides the point.]  I hope that this helps clarify...

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 12/8/2010 5:30 AM (GMT -6)   
And then there's the story where women were told to stop doing self breast exams. Too many false positives etc...
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