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Posts Tagged ‘screening policy’

May 1: PROSTABLOG NZ: The NZ Cancer Society will review the latest large-scale research studies on prostate cancer testing and screening, which have created extensive debate in the US and elsewhere.

“As far as our position statement goes, I am currently looking at starting the process for this review,”  the socety’s screening and early detection advisor, Sarah Perry, said in response to Prostablog’s question about the society’s position.

“It is a robust process involving experts both within and external to CSNZ. Hence it can take some time to complete,” said Ms Perry.

She said Prostablop was quite correct in noting that the society’s statement had not been reviewed since it was written in 1999.

“You also note the recent publication of the results from the ERSPC and PLCO trials in the New England Journal of Medicine. As you have pointed out on your blog (which is very well done I must add!) as was expected, these trials did not give the conclusive evidence as had been hoped for due to the reasons you outlined.”

The Cancer Society had not fundamentally changed its position on screening: “We do not believe a national screening programme using the PSA test would provide benefits large enough to outweigh the substantial potential harms.

“Where we have moved in regards to this issue is in taking a slightly more pragmatic approach to testing. We know PSA testing does occur in primary care. “

What CSNZ would like to see was a more informed, shared decision-making approach to this issue where each individual man, in discussion with his doctor, reviewed his personal risk for prostate cancer, the possible harms associated with PSA testing and made a decision that fitted with his own values.

Where a man chose  not to undergo testing, this was seen as equally rational as a man who did choose to get tested, said Ms Perry.

Increasingly, clinicians were also opting for active surveillance. As noted by the American Urological Association, this was because there was greater recognition that not all prostate cancers needed to be treated.

As more was understood about the nature of these cancers, such options would become routine.

“Until such time as there is a better test for prostate cancer this debate will, I fear ,continue.

“Hopefully, with more men taking a more active role in decision-making around getting tested in the first place, some of the misinformation and misunderstandings will lessen.”

The society advised Prostablog of the impending review following a request for a re-statement of its current position.

The request – made in connection with renewed international debate after last month’s publication of two large, long-term studies of screening effectiveness, and the American Urological Association’s revised policy announced this week –  has also been directed to other prostate bodies in New Zealand.

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