More doc­tors say men should think twice about prostate can­cer screen­ing

The Borneo Post - Nature and health - - Vital Signs -

MOST men shouldn’t get rou­tine prostate can­cer screen­ing be­cause the po­ten­tial ben­e­fits are small and there are clear harms, an in­ter­na­tional panel of ex­perts con­cludes. Some men, in­clud­ing those with a fam­ily his­tory of prostate can­cer, may have a greater chance of ben­e­fit from screen­ing and should dis­cuss the pros and cons with their physi­cian to make an in­formed de­ci­sion, med­i­cal ex­perts rec­om­mend in guide­lines pub­lished in the BMJ. “Most, but not all, well-in­formed men that fully un­der­stand the trade-offs would choose not to un­dergo screen­ing,” said co-au­thor of the guide­lines Dr Philipp Dahm of the Univer­sity of Min­nesota and the Minne- apo­lis Vet­er­ans Ad­min­is­tra­tion Med­i­cal Cen­tre. “Only those men who place more value in even a small re­duc­tion of prostate can­cer mor­tal­ity - these may be men at higher risk be­cause of a fam­ily his­tory or be­cause of African de­scent, or those sim­ply very con­cerned about rul­ing out a can­cer di­ag­no­sis - may opt for screen­ing,” Dahm said by email. “Shared de­ci­sion­mak­ing is needed to help them ar­rive at a de­ci­sion con­sis­tent with their own val­ues and pref­er­ences.” Most men with prostate can­cer are di­ag­nosed with lowrisk tu­mours that haven’t spread to other parts of the body. Of­ten, doc­tors and pa­tients strug­gle to choose be­tween ac­tive sur­veil­lance and treat­ments like surgery or ra­di­a­tion, be­cause it’s hard to tell which tu­mours will grow fast enough to be life-threat­en­ing and which ones might never get big enough to cause prob­lems. The prostate spe­cific anti­gen (PSA) blood test is the only widely avail­able test to screen for prostate can­cer. “PSA screen­ing in­creases the num­ber of men who need fur­ther di­ag­nos­tic tests, such as prostate biopsy (ap­prox­i­mately 100 per 1000 men screened), and it in­creases num­ber of men di­ag­nosed with prostate can­cer (18 per 1000 men screened),” said lead au­thor of the guide­lines Dr Kari Tikki­nen of Helsinki Univer­sity Hos­pi­tal and Univer­sity of Helsinki in Fin­land. – Reuters

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