“Over-diagnosis” and “over-treatment” of prostate cancer — definitions, expectations, and estimations

A conversation between two extremely knowledgeable prostate cancer advocates in comments on an earlier post has highlighted the underlying problem of what we mean by “over-diagnosis” and “over-treatment” of prostate cancer in a highly educational manner.

Frequency of PSA testing and immediacy of prostate cancer treatment among men over 70

Two recent publications have offered evidence that, at 10 and 12 years of follow-up, the potential benefits of surgical treatment for low- and intermediate-risk prostate cancer did not include any impact on overall survival for men of 65 years of age or more at the time of surgery.

Age and co-morbidity as risk factors for over-treatment of low-risk prostate cancer

In recent years, it has become increasingly well understood that patients diagnosed with low-risk prostate cancer are potentially susceptible to over-treatment. This is particularly the case among men who have significant degrees of co-morbidity and men greater than 75 years of age who have a life expectancy of < 15 years.

Diagnosis and management of low-risk disease with a PSA < 4.0

There is a good deal of media noise today about a newly published study in Archives of Internal Medicine. The study addresses the “risk profiles and treatment patterns” of US prostate cancer patients diagnosed with a PSA of ≤ 4.0 ng/ml.”

How many men are being over-treated?

Are we over-treating 50,000 men each year? Could it be even more?

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