Swedish Study

[Guest guest]

Hi guys

My doctor daughter in the States just sent me this. Interested in your comments.

Bob

Sent: 02 April 2011 05:55

To: DAD

Subject: more prostate stuff

LONDON – The longest study yet on prostate cancer testing provides more

evidence that getting screened doesn't cut the chances of dying from the

disease.

In a 20-year study of more than 9,000 Swedish men, researchers found no

difference in the rate of prostate cancer deaths between the men who were

periodically screened and those who weren't.

Routine screening for prostate cancer is controversial and the new results

aren't likely to end the debate about the value of testing. Critics say

screening leads to unnecessary biopsies and treatment with little proof that it

saves lives. Testing is done with a physical exam and a PSA blood test.

" There is no escaping the fact that we need a better tool ... to help detect

prostate cancers that actually need treating, as opposed to innocent ones that

do not, " said Malcolm Mason, a prostate cancer expert at Cancer Research U.K. in

a statement. " In the meantime, men should be fully informed about the pros and

cons of having their PSA measured. "

The standard PSA blood test looks for high levels of prostate specific antigen.

The test is controversial because the PSA level can be high for many reasons. A

positive result must be confirmed by a biopsy.

If prostate cancer is found, there's no agreement on the best way to treat it:

" watchful waiting, " surgery, hormone therapy, radiation, or some combination of

those. Most tumors grow so slowly they are never life-threatening, and the

treatments can have serious side effects.

The Swedish study was done in the eastern Sweden city of Norrkoping. From 9,026

men, about 1,500 were randomly selected to be screened every three years from

1987 to 1996. They only got digital exams on the first two visits; the PSA test

was added for the next two. For the fourth and final screening, only men aged 69

or under were included. The remaining 7,532 men were not screened.

During the 20 years of follow-up, 85 men (about 6 percent) in the screened group

and 292 men (about 4 percent) in the no-screening group were diagnosed with

prostate cancer. The death rate from prostate cancer was similar in both groups,

the researchers reported.

The tumors found in the men who got tested were smaller and mostly hadn't spread

compared to the tumors found in the other group.

" Screening for prostate cancer did not seem to have a significant effect on

mortality, " wrote Sandblom of the Karolinska Institute in Sweden and

colleagues.

The study was paid for by the Swedish Cancer Foundation and other groups. It was

published online Thursday in the journal, BMJ.

The American Cancer Society does not recommend routine screening for most men

and there is no government screening program in Britain because officials say

the PSA test is too unreliable. Two other big papers published in recent years

have also failed to show much benefit for screening. That includes a large

European study that found screening for prostate cancer could pick up cases a

decade earlier, but to prevent one death from cancer, 1,410 men would have to be

tested and 48 men treated.

False positive tests can cause significant harms, including psychological

distress and treatments that can cause impotence and incontinence