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New Study Calls into Question the Benefits of Prostate Cancer Screening

4 April 2011

A new study, performed in Sweden and published in the British Medical Journal, has called into question whether doctors should be regularly screening men for prostate cancer.  According to the study there is no long-term survivability benefit gained when comparing a group of men who received screening to a control group that did not.  This is a subject that comes up fairly often, with studies showing a case to be made both for and against screening.  I personally believe there is a great benefit in attempting to detect and treat prostate cancer early, and disagree with the methods used in this study.

As with all studies, we need to be careful to look at the data and testing methods in order to come to an educated conclusion about what is being said.  This particular study followed a group of 9,026 men over a period of 20 years, with a group of 1,494 of them being chosen at random to receive prostate cancer screening every 3 years.

A major problem with how this study was conducted is that PSA (prostate-specific antigen) levels, currently our best indicator of the presence of prostate cancer, were not monitored for the first 6 years of it.  Early screening was based entirely on digital rectal exams, which we know are not an accurate method for detecting prostate cancer when used alone.  A major part of proper screening is looking at the person as a whole to determine whether they’re at high risk for the disease; making an assessment based on those factors and what the tests tell us.  This includes performing digital rectal exams, checking PSA levels and the rate at which they rise over time, and paying attention to a patient’s family history, lifestyle, and other risk factors.

Another area not addressed is the treatment methods that men who were diagnosed with prostate cancer received.  We need to keep in mind that a lot has changed in cancer treatment over the course of 20 years, especially with the introduction of robotic surgery.  The study does state that those men who received regular screening were discovered to have smaller tumors which were less likely to have spread.  Anyone who follows my blogs and videos knows that detecting prostate cancer early plays a major role in terms of treatment options and cure rate these days.

When done properly I feel that screening is of a great benefit.  While there are studies that call PSA testing into question, it’s my opinion that it’s still one of the best tools that we have when combined with all of the information we can gather about a patient.  The fact that PSA testing was not performed in the beginning of the study instantly makes me question its validity.


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