April 1, 2009

WORSE THAN A PAIN IN THE BUTT:

Prostate cancer conundrum (Boston Globe, April 2, 2009)

MORE MEN die from prostate cancer than from any other form of the disease besides lung cancer. The development of a PSA blood test, followed by biopsies for worrisome results from the test, was supposed to bring down this death rate. But two recent large studies, one in the United States and one in Europe, indicate that the screening is causing overdiagnosis and overtreatment - with little if any gain in lives saved. The National Institutes of Health and other funders of research should put a premium on supporting scientists looking for a marker that distinguishes between aggressive prostate cancers and what scientists call "indolent" cancers.

The human cost to overdiagnosis begins with anxiety and ends, in many cases, with surgery or treatment with radiation. Incontinence and impotence are common side effects. The cost to society is hundreds of millions of dollars spent on biopsies, treatments, and lost work time for handling cancers that in most cases would not become life-threatening. The researchers in the European study calculated that they would have to screen 1,410 men and treat 48 men for every one whose life was saved.

Posted by Orrin Judd at April 1, 2009 8:56 PM
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