A balanced approach to the screening controversy

[Guest guest]

Although I think it is important for those who are

interested in the screening debate (perhaps even controversy??) to know more

about it, I do not want to get into any argument for or against screening. Strangely

most people seem to think that I am against it, but I am not; I’m against

the ignorance that accompanies the current screening regimen.

But leaving that aside, if anyone is really

interested in what seems to me to be a pretty fair and objective look at the

subject they could do worse than spend half an hour or so going through those

presentation http://www.cdc.gov/cancer/prostate/screening/slide_index.htm

It may be of particular interest to consider Slide 21 — What Happened to

U.S. Prostate Cancer Mortality Rates as Screening Rates Increased? http://www.cdc.gov/cancer/prostate/screening/slides/slide21.htm

(which shows the well known reduction in mortality rates) with Slide 22 —

What Happens to Prostate Cancer Mortality Rates in the U.K., where PSA Screening Is Rare? http://www.cdc.gov/cancer/prostate/screening/slides/slide22.htm

and to read the commentary

<SNIP> It would be easier to

conclude that PSA screening caused the decrease in U.S. mortality if studies

consistently found that mortality reductions occurred primarily in places where

there was widespread PSA screening and not in places where there was little or

no screening.

Research comparing trends in prostate cancer mortality rates

among countries shows inconsistencies in the relationship between national

mortality trends and the uptake of PSA screening.

This slide shows changes in prostate cancer mortality in the

United Kingdom,

where PSA screening is uncommon. Although U.K.

mortality rates were substantially higher than U.S.

mortality rates from the 1970s through the 1990s, mortality trends were similar

to those in the U.S.

in showing an increase during the 1980s and a decline in the 1990s.

Also, a recent study comparing screening practices and

mortality in two U.S.

regions found that PSA screening began earlier and was more common in the Seattle area than in Connecticut,

and that aggressive treatment was more common in Seattle

than in Connecticut.

However, these differences in the practice of PSA screening were not related to

differences in prostate cancer mortality over an 11-year follow-up period.

Mortality was basically the same in both regions.

These studies are not definitive but they illustrate the

complexity in determining relationships between PSA screening use and trends in

prostate cancer mortality.

For all these reasons, it is difficult to say whether PSA

screening has led to the reduction in U.S. prostate cancer mortality.

SOURCES: Oliver et al., 2001; Lu-Yao et al., 2002. <SNIP>

All the

best

Terry Herbert

in Melbourne Australia

Diagnosed

‘96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June '04:

TURP. Mar '06 PSA 17.40 fPSA 23%

My site

is at www.prostatecancerwatchfulwaiting.co.za

It is a tragedy of

the world that no one knows what he doesn’t know, and the less a man

knows, the more sure he is that he knows everything. Joyce Carey

[Guest guest]

I agree with what your saying. The mortality rates havent gone down in those cases of advanced PCa when first dxed. Its basically the same. Advanced prostate cancer has one outcome at the present. On the other hand if the screening catches the cancer early its almost always 100% curable with the right treatment. Is the cost of three false screenings "around here $45.00" worth the effort and cost to save the forth man? I wish id had one earlier. I hate to say it but more people use the very costly emergency rooms for the flu rather than wait untill monday when they could see their family doc. 2 months of this BS would cover probally 8 months of psa tests." just a guess but reality at some price for sure". Terry Herbert wrote: Although I think it is important for those who are interested in the screening debate (perhaps even controversy??) to know more about it, I do not want to get into any argument for or against screening. Strangely most people seem to think that I am against it, but I am not; I’m against the ignorance that accompanies the current screening regimen. But leaving that aside, if anyone is really interested in what seems to me to be a pretty fair and objective look at the subject they could do worse than spend half an hour or so going through those presentation http://www.cdc.gov/cancer/prostate/screening/slide_index.htm It may be of particular interest to consider Slide 21 — What Happened to U.S. Prostate Cancer Mortality Rates as Screening Rates Increased? http://www.cdc.gov/cancer/prostate/screening/slides/slide21.htm (which shows the well known reduction in mortality rates) with Slide 22 — What Happens to Prostate Cancer Mortality Rates in the U.K., where PSA Screening Is Rare? http://www.cdc.gov/cancer/prostate/screening/slides/slide22.htm and to read the commentary <SNIP> It would be easier to conclude that PSA screening caused the decrease in U.S. mortality if studies consistently found that mortality reductions occurred primarily in places where there was widespread PSA screening and not in places where there was little or no screening. Research comparing trends in prostate cancer mortality rates among countries shows inconsistencies in the relationship between national mortality trends and the uptake of PSA screening. This slide shows changes in prostate cancer mortality in the United Kingdom, where PSA screening is uncommon. Although U.K. mortality rates were substantially higher than U.S. mortality rates from the 1970s through the 1990s, mortality trends were similar to those in the U.S. in showing an increase during the 1980s and a decline in the 1990s. Also, a recent study comparing screening practices and mortality in two U.S. regions found that PSA screening began earlier and was more common in the Seattle area than in

Connecticut, and that aggressive treatment was more common in Seattle than in Connecticut. However, these differences in the practice of PSA screening were not related to differences in prostate cancer mortality over an 11-year follow-up period. Mortality was basically the same in both regions. These studies are not definitive but they illustrate the complexity in determining relationships between PSA screening use and trends in prostate cancer mortality. For all these reasons, it is difficult to say whether PSA screening has led to the reduction in U.S.

prostate cancer mortality. SOURCES: Oliver et al., 2001; Lu-Yao et al., 2002. <SNIP> All the best Terry Herbert in Melbourne Australia Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June '04: TURP. Mar '06 PSA 17.40 fPSA 23% My site is at www.prostatecancerwatchfulwaiting.co.za It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey

The prostate cancer facts, a forum for survival stats, end of life, and other issues we normally don't discuss. So if your looking for this type of support information stop on by.

Browse Archives at groups.google.com

Blab-away for as little as 1¢/min. Make PC-to-Phone Calls using Yahoo! Messenger with Voice.

[Guest guest]

Malecare uses the following phrase/statement, as our

current position:

Malecare recommends that all men,

upon attaining adulthood, discuss prostate cancer and

the latest prostate cancer screening tests, with

their physician, annually.

Note the concept of annual discussions with

physicians. This empowers men and challenges doctors

to stay on top of the latest developments and for men

to make their own choices on how they want their

health care to proceed. It also creates a venue for

considering lifestyle, lifegoals and the entire health

situation of the man, not just an abstract prostate

cancer screening disjointed from the psycho-social

profile of the patient. And, also note that this

process begins at the beginning of adulthood, when

risk reduction (eg improved diet) might actually be

lifesaving. Finally, other life threats might be

screened, treated and reduced from a man's life, from

this position.

Just an FYI for our discussion here. Darryl

http://www.malecare.com

--- sam mcdaniel wrote:

> I agree with what your saying. The mortality rates

> havent gone down in those cases of advanced PCa when

> first dxed. Its basically the same. Advanced

> prostate cancer has one outcome at the present. On

> the other hand if the screening catches the cancer

> early its almost always 100% curable with the right

> treatment. Is the cost of three false screenings

> " around here $45.00 " worth the effort and cost to

> save the forth man? I wish id had one earlier.

> I hate to say it but more people use the very

> costly emergency rooms for the flu rather than wait

> untill monday when they could see their family doc.

> 2 months of this BS would cover probally 8 months of

> psa tests. " just a guess but reality at some price

> for sure " .

>

>

> Terry Herbert wrote:

> Although I think it is important for those who

> are interested in the screening debate (perhaps even

> controversy??) to know more about it, I do not want

> to get into any argument for or against screening.

> Strangely most people seem to think that I am

> against it, but I am not; I’m against the ignorance

> that accompanies the current screening regimen.

>

> But leaving that aside, if anyone is really

> interested in what seems to me to be a pretty fair

> and objective look at the subject they could do

> worse than spend half an hour or so going through

> those presentation

>

http://www.cdc.gov/cancer/prostate/screening/slide_index.htm

> It may be of particular interest to consider Slide

> 21 — What Happened to U.S. Prostate Cancer Mortality

> Rates as Screening Rates Increased?

>

http://www.cdc.gov/cancer/prostate/screening/slides/slide21.htm

> (which shows the well known reduction in mortality

> rates) with Slide 22 — What Happens to Prostate

> Cancer Mortality Rates in the U.K., where PSA

> Screening Is Rare?

>

http://www.cdc.gov/cancer/prostate/screening/slides/slide22.htm

> and to read the commentary

>

> <SNIP> It would be easier to conclude that PSA

> screening caused the decrease in U.S. mortality if

> studies consistently found that mortality reductions

> occurred primarily in places where there was

> widespread PSA screening and not in places where

> there was little or no screening.

>

> Research comparing trends in prostate cancer

> mortality rates among countries shows

> inconsistencies in the relationship between national

> mortality trends and the uptake of PSA screening.

>

> This slide shows changes in prostate cancer

> mortality in the United Kingdom, where PSA screening

> is uncommon. Although U.K. mortality rates were

> substantially higher than U.S. mortality rates from

> the 1970s through the 1990s, mortality trends were

> similar to those in the U.S. in showing an increase

> during the 1980s and a decline in the 1990s.

>

> Also, a recent study comparing screening practices

> and mortality in two U.S. regions found that PSA

> screening began earlier and was more common in the

> Seattle area than in Connecticut, and that

> aggressive treatment was more common in Seattle than

> in Connecticut. However, these differences in the

> practice of PSA screening were not related to

> differences in prostate cancer mortality over an

> 11-year follow-up period. Mortality was basically

> the same in both regions.

>

> These studies are not definitive but they

> illustrate the complexity in determining

> relationships between PSA screening use and trends

> in prostate cancer mortality.

> For all these reasons, it is difficult to say

> whether PSA screening has led to the reduction in

> U.S. prostate cancer mortality.

>

> SOURCES: Oliver et al., 2001; Lu-Yao et al., 2002.

> <SNIP>

>

>

>

> All the best

>

> Terry Herbert

> in Melbourne Australia

> Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason

> 3+3=6: No treatment. June '04: TURP. Mar '06 PSA

> 17.40 fPSA 23%

> My site is at

> www.prostatecancerwatchfulwaiting.co.za

> It is a tragedy of the world that no one knows

> what he doesn’t know, and the less a man knows, the

> more sure he is that he knows everything. Joyce

> Carey

>

>

>

>

>