Media discussion of the implications of the articles in the New England Journal of Medicine continues to proliferate. Among the most recent are:
- An excellent article by Bernadine Healy, MD in US News and World Report entitled, “Should Obama Get a PSA Test? On Prostate Cancer Screening and Comparative Effectiveness“
- An editorial in the Boston Globe arguing the importance of an accelerated emphasis on the search for better and more accurate prostate cancer tests
- A CNN report entitled, “Prostate cancer screening: what’s a dude to do?”
And for those in the UK who think that these data will encourage the National Health Service to promote national screening for prostate cancer, we recommend a dose of reality, as presented by
- A commentary from the NHS National Prescribing Center entitled, “Prostate cancer screening: no compelling evidence that benefits outweigh harms“
The “New” Prostate Cancer InfoLink would point out that one of the very real benefits of the publication of the two articles on screening in the New England Journal of Medicine has been the massive public visibility of the critical issues around the early detection of clinically significant prostate cancer (which is essential) and the role of mass screening in achieving this result (which is more controversial).
The prostate cancer advocacy and treatment communities would do well to take advantage of this visibility to emphasize the very real needs highlit by this issue.
Search for new and
ongoing trials on the
CTAG PCa web site
“And for those in the UK who think that these data will encourage the National Health Service to promote national screening for prostate cancer, we recommend a dose of reality, as presented by …”
I for one do not believe a national screening program for prostate cancer will be set up within the UK, using the DRE and PSA test. The PSA test is not a direct test for prostate cancer, so this does not meet the criteria to enable such a program to exist.
What is required is promoting greater awareness relating to prostate cancer and highlighting the tests that are available along with the +/-’s that come with both initial tests. This is being done and is seen to be the case, especially over the last 2 years or so!
It’s up to the individual at the end of the day whether he has a PSA test or not.
I’d like to give one example showing maybe the difference in the UK compared to the USA relating to PSA testing:
A neighbour (early 60s) had pains in his back and legs and after two weeks of tests they finally did a PSA test. He had never had one before and his results were sky high! After further tests which proved it was PC and that it had already spread to his bones, he told me he was given a year to live.
Whether a National Screening Program or just greater awareness was in place 10/20 years would have caught the PC earlier and at a treatable stage is obviously a matter for debate.
I sympathise with your neighbour, but is the implication arising from this one case that every man above the age of 40 in the UK should be screened?
Now I like this quote: “All 47-year-old African-American men must have PSA testing done, even if they are not president of the United States.” Thank you from the bottom of my heart, Dr. Gill.
Axotyl,
That was just one example with many more similar cases.
The UK National Screening Committee is to review the evidence on prostate cancer screening after the results of the two major studies into the effectiveness of screening.
As I have said before, I doubt very much a national screening program will be put in place here in the UK but what we will and are seeing is a big push in PC awareness campaigns. This then gives men the information to enable them to make a choice whether to get tested or not.
So, the answer to your question would be no and for many reasons,in my opinion.
Do I think it’s a good idea for men to get tested at 40? The answer to that would be yes — especially if they fall into the “at risk category” or, after taking all the positives/negatives associated with the DRE and PSA tests on board, they believe it wise to gain initial results to form a datum for future reference.
5thString,
I’m all for a push in PC awareness campaigns in the UK.
You did see one of the conclusions from the European study was: “….over a period of nine years, in order to prevent one death from prostate cancer, 1,410 men have to be screened, and 48 men would have to be treated for prostate cancer despite the fact that they would not be harmed by the condition”?
Do you feel that is a reasonable basis for a national screening programme?
Axotyl,
I think I have answered that question Re “5thString, on April 5th, 2009 at 4:58 am Said:”
Just to add that the PSA test along with the DRE are the only initial tests that are available to check for possible PC at an early stage or if tested too late that there is a major problem which then costs lots of money to treat if able to treat at all!