Comments on: What’s the latest on prostate cancer and the PSA screening test? http://www.kevinmd.com/blog/2009/09/latest-prostate-cancer-psa-screening-test.html Wed, 15 Feb 2012 00:14:00 +0000 hourly 1 By: jeffrey dach mdhttp://www.kevinmd.com/blog/2009/09/latest-prostate-cancer-psa-screening-test.html#comment-113527 jeffrey dach md Thu, 08 Oct 2009 12:46:57 +0000 http://www.kevinmd.com/blog/?p=40430#comment-113527 Although PSA screening eradicated advanced prostate cancer from the population, there was a downside.According to Welch's report in August JNCI, one million men were overdiagnosed and overtreated for prostate cancer over the last twenty years.Why was PSA Screening for Prostate Cancer, a 20 year failed Medical Experiment ? Get the whole story here...http://jeffreydach.com/2009/10/01/psa-testing-the-failed-medical-experiment-by-jeffrey-dach-md.aspx Although PSA screening eradicated advanced prostate cancer from the population, there was a downside.

According to Welch’s report in August JNCI, one million men were overdiagnosed and overtreated for prostate cancer over the last twenty years.

Why was PSA Screening for Prostate Cancer, a 20 year failed Medical Experiment ? Get the whole story here…

http://jeffreydach.com/2009/10/01/psa-testing-the-failed-medical-experiment-by-jeffrey-dach-md.aspx

]]> By: Healthcare Observerhttp://www.kevinmd.com/blog/2009/09/latest-prostate-cancer-psa-screening-test.html#comment-112925 Healthcare Observer Mon, 28 Sep 2009 15:52:57 +0000 http://www.kevinmd.com/blog/?p=40430#comment-112925 I can't believe 'Libertarian Urologist' is a real doc - but if he is, his lack of knowledge about cancer statistics is very worrying. Let's hope in that case he's well away from oncology. I can’t believe ‘Libertarian Urologist’ is a real doc – but if he is, his lack of knowledge about cancer statistics is very worrying. Let’s hope in that case he’s well away from oncology.

]]> By: NoVA dochttp://www.kevinmd.com/blog/2009/09/latest-prostate-cancer-psa-screening-test.html#comment-112922 NoVA doc Mon, 28 Sep 2009 15:09:02 +0000 http://www.kevinmd.com/blog/?p=40430#comment-112922 IIRC: prostate CA 5yr survival in the US is an incredibly high 99% and annual fatalities are about 30K. Cardiovascular disease kills more than 10x as many men annually. And as for pharmacologic prevention: NNT with a statin to prevent an MI is about 70, and pravastatin is <strong>$4/month</strong>. NNT with a 5-alpha reductase inhibitor is about 500-ish, and those cost is <strong>$3/pill</strong>.Now, as a PCP, I need to look at the big picture - now if only I could only get my patients' statin compliance up... IIRC: prostate CA 5yr survival in the US is an incredibly high 99% and annual fatalities are about 30K. Cardiovascular disease kills more than 10x as many men annually. And as for pharmacologic prevention: NNT with a statin to prevent an MI is about 70, and pravastatin is $4/month. NNT with a 5-alpha reductase inhibitor is about 500-ish, and those cost is $3/pill.

Now, as a PCP, I need to look at the big picture – now if only I could only get my patients’ statin compliance up…

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/09/latest-prostate-cancer-psa-screening-test.html#comment-112919 Anonymous Mon, 28 Sep 2009 14:40:53 +0000 http://www.kevinmd.com/blog/?p=40430#comment-112919 Those numbers you give are meaningless in this debate. If your denominator includes a number of cancers that were never going to be fatal than your quotient t is going to be a lower number. Great Britain preferentially diagnoses more fatal cancers while the U.S. statistics are padded with a bunch of indolent ones due to more aggressive screening. It's a simple overdiagnosis statistical bias and you should know better. And don't quote me 5-year survival rates either as we all know those are rife with lead-time bias. Those numbers you give are meaningless in this debate. If your denominator includes a number of cancers that were never going to be fatal than your quotient t is going to be a lower number. Great Britain preferentially diagnoses more fatal cancers while the U.S. statistics are padded with a bunch of indolent ones due to more aggressive screening. It’s a simple overdiagnosis statistical bias and you should know better. And don’t quote me 5-year survival rates either as we all know those are rife with lead-time bias.

]]> By: A Libertarian Urologisthttp://www.kevinmd.com/blog/2009/09/latest-prostate-cancer-psa-screening-test.html#comment-112918 A Libertarian Urologist Mon, 28 Sep 2009 14:04:04 +0000 http://www.kevinmd.com/blog/?p=40430#comment-112918 Prostate cancer is fatal to 19 percent of its American patients. The National Center for Policy Analysis reports that it kills 57 percent of Britons it strikes. The nonsense that Medpage quotes is consistant with the current medical political agenda of rationing and more propaganda of this type will surely appear in the future with regards to screening for any disease at all. A lot of what primary care physicians do is considered screening, so maybe a study will soon appear that primary care is obsolete. Prostate cancer is fatal to 19 percent of its American patients. The National Center for Policy Analysis reports that it kills 57 percent of Britons it strikes. The nonsense that Medpage quotes is consistant with the current medical political agenda of rationing and more propaganda of this type will surely appear in the future with regards to screening for any disease at all. A lot of what primary care physicians do is considered screening, so maybe a study will soon appear that primary care is obsolete.

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