Comments on: Lowering the PSA threshold for financial gain? http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html medical blog Sun, 22 Nov 2009 14:15:05 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html/comment-page-1#comment-73865 Anonymous Fri, 13 Apr 2007 00:18:00 +0000 http://clients.emmense.com/kevinmd/2007/04/lowering-the-psa-threshold-for-financial-gain.html#comment-73865 "overdiagnosis"<br/><br/>That is a hard term to pin down. Tomorrow, I am operating on a 59yo with 5% of 1/12cores positive for Gleason 3+3 PSA 5. Would you call this insig cancer preoperatively? I'll let you know what the final path shows. Bottomline, prostate cancer death rates have fallen for the first time so we must be doing something right. “overdiagnosis”

That is a hard term to pin down. Tomorrow, I am operating on a 59yo with 5% of 1/12cores positive for Gleason 3+3 PSA 5. Would you call this insig cancer preoperatively? I’ll let you know what the final path shows. Bottomline, prostate cancer death rates have fallen for the first time so we must be doing something right.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html/comment-page-1#comment-73848 Anonymous Thu, 12 Apr 2007 14:26:00 +0000 http://clients.emmense.com/kevinmd/2007/04/lowering-the-psa-threshold-for-financial-gain.html#comment-73848 So, if the threshold is lowered, how much overdiagnosis there will be? Any estimates? So, if the threshold is lowered, how much overdiagnosis there will be? Any estimates?

]]> By: Anonymous http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html/comment-page-1#comment-73833 Anonymous Wed, 11 Apr 2007 23:28:00 +0000 http://clients.emmense.com/kevinmd/2007/04/lowering-the-psa-threshold-for-financial-gain.html#comment-73833 "Of course, urologists wouldn't financially benefit from the additional procedures resulting from a lower PSA threshold, would they?"<br/><br/>Come on, as urologists our waiting rooms are loaded with patients already. My schedule is booked over 8 weeks out. This is not about financial incentive; it is about finding the more aggressive cancers in younger men at a more treatable stage. Although I will probably get blasted for this, I routinely tell patients over the age of 75 to stop checking their PSA. The AUA needs to alter their PSA screening guidelines and needs to come to a consensus at what age to stop screening PSA. Maybe aggressively screening 40-60 year old men by lowering PSA thresholds will then allow us to stop PSA screening in men over 70 years of age? The problem is that this type of data needs years to mature. “Of course, urologists wouldn’t financially benefit from the additional procedures resulting from a lower PSA threshold, would they?”

Come on, as urologists our waiting rooms are loaded with patients already. My schedule is booked over 8 weeks out. This is not about financial incentive; it is about finding the more aggressive cancers in younger men at a more treatable stage. Although I will probably get blasted for this, I routinely tell patients over the age of 75 to stop checking their PSA. The AUA needs to alter their PSA screening guidelines and needs to come to a consensus at what age to stop screening PSA. Maybe aggressively screening 40-60 year old men by lowering PSA thresholds will then allow us to stop PSA screening in men over 70 years of age? The problem is that this type of data needs years to mature.

]]> By: Kevin http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html/comment-page-1#comment-73827 Kevin Wed, 11 Apr 2007 22:42:00 +0000 http://clients.emmense.com/kevinmd/2007/04/lowering-the-psa-threshold-for-financial-gain.html#comment-73827 Not at all! However, the comment did not add to the discussion of the blog entry.<br/><br/>Thanks,<br/>Kevin Not at all! However, the comment did not add to the discussion of the blog entry.

Thanks,
Kevin

]]> By: Anonymous http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html/comment-page-1#comment-73825 Anonymous Wed, 11 Apr 2007 22:11:00 +0000 http://clients.emmense.com/kevinmd/2007/04/lowering-the-psa-threshold-for-financial-gain.html#comment-73825 Did I hurt your feelings Kevin? Did I hurt your feelings Kevin?

]]> By: The Independent Urologist http://www.kevinmd.com/blog/2007/04/lowering-psa-threshold-for-financial.html/comment-page-1#comment-73821 The Independent Urologist Wed, 11 Apr 2007 19:39:00 +0000 http://clients.emmense.com/kevinmd/2007/04/lowering-the-psa-threshold-for-financial-gain.html#comment-73821 Lower PSA value thresholds are meant for younger patients who will die of prostate cancer if left undetected. What is really needed beginning at age 40-50 is agood informed consent discussion between the urologist and the patient, giving data (Catalona's) regarding lower PSA thresholds. is that what you tell your patients Kevin. Lower PSA value thresholds are meant for younger patients who will die of prostate cancer if left undetected. What is really needed beginning at age 40-50 is agood informed consent discussion between the urologist and the patient, giving data (Catalona’s) regarding lower PSA thresholds. is that what you tell your patients Kevin.

]]>