If you are a man, you’ve probably had the fear of prostate cancer drilled into you — along with the idea that it is critical to your health, and probably your life, to have regular prostate cancer screenings. But two just released large randomized trials indicate that if there is any benefit to screening, it is extraordinarily small. The authors of a review of this research, just published in CA: A Cancer Journal for Clinicians, Otis W. Brawley, M.D. of the American Cancer Society and Donna Ankerst, Ph.D. and Ian M. Thompson, M.D. of the University of Texas Health Science Center at San Antonio, say that prostate cancer is almost inevitable in men as they grow older, so a medical goal to find more prostate cancers is not acceptable.
In fact, they point out that principles of good public health policy call for screenings only if they reduce the risk of death and/or suffering from prostate cancer, or reduce health care costs when compared with a non-screening scenario. And according to the new research, prostate cancer screenings do none of these things. But they can cause havoc in a man’s life.
Actually, although the mainstream media frequently hawks cancer screenings for everyone, no major medical group, including the American Cancer Society, currently recommends routine screening for men at average risk for prostate cancer. In an editorial accompanying the CA: A Cancer Journal for Clinicians study review, Peter Boyle, Ph.D., D.Sc., of the International Prevention Research Institute, Lyon, France and Dr. Brawley state “the real impact and tragedy of prostate cancer screening is the doubling of the lifetime risk of a diagnosis of prostate cancer with little if any decrease in the risk of dying from this disease.”
In 1985, before PSA (prostate specific antigen) testing was available, a US male had an 8.7 percent lifetime risk of being diagnosed with prostate cancer and his lifetime risk of dying from the cancer was 2.5 percent . By 2005, with PSA testing widespread, an American male’s lifetime risk of being diagnosed with prostate cancer had climbed to 17 percent and he had a three percent risk of dying from the disease.
In a statement to the media, the authors of the current study point out that even in the best case scenario, applying the findings of a European trial that found PSA screening led to a 20 percent reduction in the risk of death, the average man who goes through PSA testing sees his risk of being labeled a “cancer patient” soar from about nine percent to at least 17 percent. However, the screening barely decreases his risk of prostate cancer death at all — it only drops from a lifetime risk of three percent to a lifetime risk of 2.4 percent.
The report discusses how a computer modeling study using National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) registries estimated that more than one in four cancers detected in white males (29 percent) and almost 50 percent of cancers detected in black males were over-diagnosed cancers. What’s more, when a similar model using data from Europe was studied, the researchers estimated a 50 percent over-diagnosis rate of prostate cancer. Why is this alarming and even harmful to men? Because those diagnosed with clinically insignificant tumors are subject to unnecessary diagnostic tests and unneeded treatment and often suffer psychosocial harm and sexual side effects.
In addition, the authors point out, it is no small thing for men to be stuck with the label “cancer patient,” which can have negative consequences on their ability to earn a living and cost of their health insurance. What’s more, over diagnosing prostate cancer significantly affects five year survival statistics, which makes them totally inaccurate in showing progress in cancer treatment and control.
Bottom line: the researchers conclude that “men should discuss the now quantifiable risks and benefits of having a PSA test with their physician and then share in making an informed decision…the weight of the decision should not be thrown into the patient’s lap.”
As recently reported in Natural News, Dr. Brawley also published research in the New England Journal of Medicine this month showing that prostate cancer screenings are virtually useless at saving lives (http://www.naturalnews.com/026477_c…). Another Natural News article pointed out that one good way to avoid prostate cancer is to avoid statin drugs which have been linked to the disease (http://www.naturalnews.com/025218.html).
Screening for Prostate Cancer, Otis W. Brawley, MD; Donna Ankerst, PhD; and Ian M. Thompson, MD, CA Cancer J Clin, July/Aug 2009 doi:10.3322/caac.20026.
Prostate Cancer: Current Evidence Weighs Against Population Screening, Peter Boyle, PhD, DSc; Otis W. Brawley, MD, CA Cancer J Clin, July/Aug 2009 doi:10.3322/caac.20025.
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