Doctors Warn of Against Over-Diagnosing and Over-Treating Prostate Cancer
According to a news article, experts are warning that doctors may be over-diagnosing and over-treating patients who are believed to have prostate cancer. A collection of large scale studies from the U.S. and Europe show that the current screening is flawed.
One large scale U.S. study concludes annual screening and exams will have no effect on mortality rate over the next 11 years.
Current Prostate Caner Screening Process
- Doctors currently use a process which measures PSA levels in the blood.
- Prostate-specific antigens (PSA) are a protein that doctors believe increase in numbers when prostate cancer occurs.
- Currently, a sample with 4 nanograms of PSA per milliliter of blood is considered a red flag for prostate cancer.
Issues with Prostate Cancer Screening
“We’re over-diagnosing it, and we’re over-treating too many men. The way the test is used today is wrong.” – Richard Ablin, University of Arizona College of Medicne
- Critics of PSA screening point out that PSA levels are not cancer specific.
- PSA levels may rise upon prostate enlargement or inflammation.
- A 1997 study found that of men with PSA levels above 4 nanograms per milliliter of blood, 65 to 75 percent were cancer free.
- A 2004 New England Journal of Medicine study showed that 15 percent of all men who were tested and had a PSA level below 4 already had prostate cancer.
- A 2009 U.S. study of 76,693 men at 10 different research centers concluded that over 11 years, annual PSA screenings plus digital rectal exams would have no effect on prostate cancer mortality rates.
- A European study of 182,000 men also conducted in 2009 found that while a PSA every 4 years did reduce mortality rates by 20 percent, for each life saved a doctor had to screen 1,410 men and put 48 through unnecessary treatment.
Dangers of Unnecessary Prostate Cancer Treatment
- Financially damaging as treatments and surgery can be expensive.
- Misdiagnoses may lead to radiation treatment.
- Eventual surgery can cause incontinence and impotence.
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