PSA or Not, More analysis

Nice summary of the findings of the two PSA studies in the NY Times.

“The European study found that for every man who was helped by P.S.A. screening, at least 48 received unnecessary treatment that increased risk for impotency and incontinence. Dr. Otis Brawley, chief medical officer of the American Cancer Society, summed up the European data this way: “The test is about 50 times more likely to ruin your life than it is to save your life.””

Medicynic: How about a comparison to the use of adjuvant treatments for example in breast cancer or colon cancer where 100 people are treated with expensive highly toxic medications to benefit 10%. Admittedly breast cancer has a higher mortality but the costs are exponentially higher.

“For older men, the screening decision should be easier. P.S.A. screening is already not advised for those 75 and older.”

For middle aged patients:

“The advice is murkier for middle-age men. In the European study, 50- to 54-year-olds didn’t benefit from screening. But men ages 55 to 69 were 20 percent less likely to die from prostate cancer than those who weren’t screened.

Medicynic: The articles would have been more powerful with an economic analysis. Cost effectiveness data would help place it in perspective with other interventions.

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