Doctors Receptionists

[minestrone]

yeah why bother with prostate cancer screening?

Prostate cancer survival statistics : Cancer Research UK

Ten year survival = 68%

you are only 9% more likely to die from it than breast cancer which has an expensive & extensive screening programme.

Breast cancer survival statistics : Cancer Research UK

Ten year survival rate 77%

As SE says prostrate testing is really not worth it.

[vetran]

As SE says prostrate testing is really not worth it.

why?

Obviously I defer to an expert like Cancer research:

Relative survival rates at five years for prostate cancer are mainly dependent on the amount of PSA testing in the population and on the success of treatment.4 In men, five-year relative survival rates for prostate cancer increased from 31.0% in England and Wales during 1971-1975 to 81.4% in England during 2005-2009 (Figure 3.2).5,10-12

Survival from prostate cancer is strongly related to the stage of the disease at diagnosis. For disease which is confined to the prostate, five-year relative survival for patients in England in 1999-2002 is 90% or more, but if the disease is metastatic at presentation five-year relative survival is lower at around 30%

So they seem to believe (and have the stats to back it up) that testing is the best way to increase survival rates.

or is it because it tends to strike older men and you believe they don't count?

[doodab]

There is actually a debate about whether even breast cancer screening is "worth it". The trouble with any screening program is that you get false positives and/or cause people undue worry when you find and treat something (treatment may well have undesirable side effects) that was never actually going to cause them a problem. These downsides can outweigh the benefits.

Overdiagnosis is when people receive unnecessary cancer treatment for a cancer that would not otherwise have been diagnosed. For every death prevented by screening, there are estimated to be three cases of overdiagnosis.

Breast cancer screening 'may not reduce deaths' - Health News - NHS Choices

In the case of prostate cancer, the numbers are even less favourable:

To save one life from prostate cancer, the study showed that 48 men would have to be treated. This means many men would be diagnosed with prostate cancer that would otherwise not have been detected or required treatment. “The majority of PSA-detected prostate cancers are harmless,” says Dr Parker.

...

A positive diagnosis can lead to anxiety and is often followed by treatment, with its risks to sexual, bladder and bowel function. Black men and those with a family history of the disease are at greater risk and might have more to gain from screening. “It is in some ways a lifestyle choice,” says Dr Parker. “If you want to do everything to maximise your chances of living to a great age, and are willing to risk the side effects of treatment, then PSA testing makes sense. “If, on the other hand, you are more accepting of your ‘allotted span’, and are keen to preserve normal sexual and urinary function, then you may decide not to have the test.”

Prostate cancer screening - Live Well - NHS Choices

I for one don't think that compulsory prostate screening is for me.

[vetran]

Surely that is a failing in the treatment process not PSA screening?

A screening process should reduce the number requiring additional scrutiny to a manageable level not define a group for treatment regardless of need.

If 49 people test positive you then do additional testing and monitoring to decide which one of them require treatment. The screening means you do that on 49 people not 10,000.

Its not a pregnancy test (99.9% accurate) yet!

[mudskipper]

They've refined the process for cervical cancer screening in our area (I don't believe it's nationwide yet).

Basically if you get a 'positive' grade 1 (least worrying) result from your smear test, they test for HPV. If you're negative for that, then no treatment. Previously everyone would have got treatment although most would never have gone on to develop cancer.

[d000hg]

If the government brought in annual checkups I'd wager many of those in this thread would be banging on about the "nanny state" and "I won't be told when to see a doctor".

[vetran]

If the government brought in annual checkups I'd wager many of those in this thread would be banging on about the "nanny state" and "I won't be told when to see a doctor".

yes but the sensible ones would see it as a massive improvement in our life, especially if it led to a reduction in critical illness.

[d000hg]

yes but the sensible ones would see it as a massive improvement in our life, especially if it led to a reduction in critical illness.

Like YOU would ever go for anything the government suggests that increases how much they tell you how to live your life. Within 5 minutes you'd be frothing on here about how insurance companies are going to access your annual checkup data, your employer demands to see the results, etc.

[doodab]

Surely that is a failing in the treatment process not PSA screening?

A screening process should reduce the number requiring additional scrutiny to a manageable level not define a group for treatment regardless of need.

If 49 people test positive you then do additional testing and monitoring to decide which one of them require treatment. The screening means you do that on 49 people not 10,000.

The point of screening is to catch it early, because early diagnosis & treatment improves survival rates. The problem is that the test cannot tell who will go on to develop a serious problem, and if you wait and see which cancers become serious enough to require treatment you lose the benefit of early diagnosis and treatment. You may as well just wait for people to develop serious problems.

[vetran]

Like YOU would ever go for anything the government suggests that increases how much they tell you how to live your life. Within 5 minutes you'd be frothing on here about how insurance companies are going to access your annual checkup data, your employer demands to see the results, etc.

that would need to be legislated against yes.