Early detection is still the key to fighting prostate cancer
Re: “Don’t make yourself sick fretting over medical tests,” Susan Martinuk, Opinion, June 15.
I would like to respond to Susan Martinuk’s column on overuse of medical screening in the general population and whether it’s worth the accompanying risks. As a urologist who has practised for over 30 years and chair of Calgary’s Prostate Cancer Centre, my comments are restricted to PSA testing.
The Prostate Cancer Centre supports PSA (Prostate Specific Antigen) blood testing and recommends men age 40 and over discuss the benefits of screening for prostate cancer (PSA and digital rectal exam) with their family physician.
The debate on whether to screen misses the point. PSA testing is just one tool a urologist would use to determine whether to order further tests.
It is like checking the oil in your car to determine if you need a new engine. You would look at a host of other information to make that determination.
The U.S. Preventative Services Task Force, which recently recommended against PSA screening, did not have a single physician who treats prostate cancer on the team, and they ignored the recent longerterm analyses of the large European studies that showed that PSA screening decreased the relative risk of death.
The five-year survival rate for prostate cancer patients in Alberta has increased from 69 per cent in 1992 to 93 per cent in 2008, mainly due to PSA testing.
The best evidence demonstrates screening will reduce mortality. In Canada in 2012, an estimated 26,500 men will be diagnosed with prostate cancer and 4,000 will die of it.
In Alberta in 2012, an estimated 2,500 Alberta men will be diagnosed with prostate cancer and 370 will die of it. Early detection saves lives.
Bryan Donnelly, MD, Calgary