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Posts Tagged ‘over-diagnosis’

URO TODAY: The reasons why prostate cancer screening does not give the expected outcomes in terms of saving lives are explored in a recent research article:

Recognition of the discrepancy between the expected and the actual impact of [cancer] screening and recognition of over-diagnosis as a source of harm may be critical for understanding and projecting the potential impact of cancer screening programmes. READ MORE>

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URO TODAY: The common claim that PSA testing leads to high and unacceptable levels of prostate cancer over-detection – and therefore over-treatment – is an exaggeration, according to a presentation at the 107th annual meeting of the New York Section of the American Urology Association. READ MORE>

In this 69-page slide presentation, Dr William J Catalona – the US “father” of the PSA test – analyses a number of studies of PSA testing and seeks to discredit those which show testing leads to over-diagnosis and treatment:

Over-detection is a relatively small issue when considered in the context of the larger issue of preventing suffering and death from prostate cancer, especially when good clinical judgement is used and patients receive appropriate, effective and high quality treatment.

He is critical of what he calls the premature reporting of two big randomised studies of PSA testing earlier this year, saying much more followup time is needed before meaningful results can be obtained.

Notwithstanding that, Dr Catalona – a professor at Northwestern University in the US –  refers to the European study (ERSPC) in making this observation about whether men should choose to be tested:

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URO TODAY: The introduction of PSA screening has resulted in more than 1 million additional men being diagnosed and treated for prostate cancer in the United States. The growth is particularly dramatic for younger men. READ MORE>

Given the considerable time that has passed since PSA screening began, most of this excess incidence must represent over-diagnosis.

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URO TODAY: PSA screening reduces the risk of dying of prostate cancer by up to 31% in men actually screened, and this benefit should be weighed against a degree of over-diagnosis and over-treatment inherent in prostate cancer screening. This finding comes from deeper analysis of the large randomised European study reported earlier this year. READ MORE>

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JULY 11: ASSOCIATED PRESS: One in three breast cancer patients identified in public screening programs may be treated unnecessarily, a new study says. Doctors and patients have long debated the merits of prostate cancer screening out of similar concerns that it over-diagnoses patients. READ MORE>

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JUNE 30:  SCIENCE CODEX.COM: The two recently reported large randomised studies in Europe and the US illustrate that the price to pay for 20% reduction in prostate cancer deaths is high – over-diagnosis and over-treatment are great problems. The answers lie in improving the PSA test or finding biomarkers that effectively separate aggressive cancers from slow-growing ones. READ MORE>

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JUNE 8: NZ DOCTOR: Some 50 per cent of men diagnosed via a PSA test would never experience symptoms if left untreated, says a NZ epidemiologist who has analysed the large randomised studies reported recently. READ MORE>

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