Study dents confidence in prostate cancer tests
- From: J <studras@xxxxxxxx>
- Date: Sun, 15 Jan 2006 07:02:36 -0500
<http://www.indystar.com/apps/pbcs.dll/article?AID=/20060115/NEWS06/601150404/1012/NEWS06>
January 15, 2006
Study dents confidence in prostate cancer tests
By Nicholas Bakalar
The New York Times
Men who have been screened for prostate cancer by the most commonly used
tests have no greater chance of surviving the disease than those who have
not been screened at all, new research has found.
A report on the research, published this past week in The Archives of
Internal Medicine, found that neither a prostate specific antigen test,
known as a PSA, nor a rectal examination worked to reduce deaths from
prostate cancer.
The value of the screening has long been a matter of debate. A PSA level
can be abnormal even when a man does not have prostate cancer. But when an
abnormal PSA level is discovered, typically the next step is a biopsy.
Even a biopsy is inconclusive, however. The tissue sample from a negative
screening, for example, may by chance have come from a part of the
prostate that is free of cancerous cells.
Even if a cancer is found, an operation, which often causes erectile
dysfunction and incontinence, may not be necessary because many cancers
grow so slowly that they will never cause a problem.
Dr. John Concato, a researcher for the Veterans Affairs Connecticut
Healthcare System and the lead author of the paper, stressed that a
physician is obligated to clarify all the issues for patients.
"He should explain the benefits and risks, in the context of each
patient's values," Concato said. "For example, some patients place such a
high premium on avoiding incontinence and impotence that a positive PSA
test can be problematic."
The research involved nearly 72,000 men older than 50 who received
outpatient care at any of 10 Veterans Affairs hospitals in New England.
Of this group, the scientists identified 1,425 men with prostate cancer
that was diagnosed from 1991 to 1995, then studied the records of 501
patients who had died of the disease as of 1999.
For each case, the researchers randomly selected a living patient to be
part of a control group.
Screening with PSA had been performed for 70 of the men who died and for
65 men in the control group used for comparison.
If screening had been effective, a lower proportion of screened patients
would have been found among the group of men who had died. But this was
not the case.
.
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