Gli esperti dovrebbero sconsigliare lo screening di routine del cancro alla prostata per la maggior parte degli uomini nel Regno Unito
https://www.bbc.co.uk/news/live/clykgr941ddt
di iwaterboardheathens
Gli esperti dovrebbero sconsigliare lo screening di routine del cancro alla prostata per la maggior parte degli uomini nel Regno Unito
https://www.bbc.co.uk/news/live/clykgr941ddt
di iwaterboardheathens
16 commenti
Ngl I’m very curious to know the reasons why when they release the report.
Because “it can do more harm than good” isn’t convincing to the general public
it’s always said to be best to follow the experts, follo the scienc. So people should be happy with this.
Good summary here:
[https://canadiantaskforce.ca/tools-resources/prostate-cancer-harms-and-benefits/](https://canadiantaskforce.ca/tools-resources/prostate-cancer-harms-and-benefits/)
“What are my risks if I don’t get screened?
* Among men who *are screened* with the PSA test, the risk of dying from prostate cancer is 5 in 1,000
* Among men who *are not screened* with the PSA test, the risk of dying from prostate cancer is 6 in 1,000”
so 1:1000 improvement in risk of dying.
I think it’s an individual choice. If you would want the reassurance of a negative test, then get one done, but know the risks and benefits. There are lots of other diseases that you could also test for.
If you have a screening test suggest a cancer, eg a PSA blood test, you then need a more invasive test to confirm the cancer. These cause harm and not all of them subsequently prove a cancer is present.
Even if a cancer is diagnosed there are multiple biases in screening which need to be considered.
Lead time bias. If we diagnose a cancer at 80 with symptoms and you die at 85, your life expectancy with the disease is five years. If we diagnose it at 75 by screening and don’t do anything, you still die at 85 but life expectancy has doubled.
Length time bias – screening is more likely to detect slow growing low risk cancers, which are less dangerous if/when they present with symptoms anyway.
Overdiagnosis bias – screening catches cancers which would never have caused a problem but once found are often treated. Patients have surgery/chemo/radio which does them no good and often causes harm
With breast cancer for example about 4000 women per year are treated for cancers which statistically wouldn’t have ever bothered them because they’ve been found via screening – https://news.cancerresearchuk.org/2017/01/10/breast-screening-can-lead-to-some-women-having-unnecessary-treatment/
Surely if you have a Psa test and it’s abnormal, your GP can ask for a MRI/CT scan? My GP wanted to make sure I didn’t have a cancerous lump in my lung, I had a CT scan and then I was told it was clear, surely they can do that for the prostate too?
Imagine if we had the technology to do a non invasive scan for women and didn’t do it there’d be uproar.. but it’s ok it’s just men.
As someone who has just been through this, my thoughts are mixed.
The problem with the PSA test is that it is a very very blunt instrument. All it indicates is a higher than expected PSA level for your age, it cannot say WHY this is, and prostate cancer is only one of a number of possibilities.
The next step is usually an MRI scan – this can help reduce the need for biopsies if nothing obvious is found.
The final step is a trans-perineal prostate biopsy, which I can assure you, is not an experience most men will relish..
So, potentially a UK wide screening using the PSA test could lead to vast numbers of unnecessary scans and biopsies, tying up urology, radiology and surgical departments which are already overstretched (health board dependant of course).
If you look up Med Man on youtube, he has a recent video talking about a ‘PSE’ test which is much more accurate. to my mind, if/when this becomes more available/accepted/affordable then a screening program makes much more sense.
However, every bloke over 45 should look up the symptoms of prostate cancer and pay attention to them. If you have them, see your doctor.
Oh this must be like when they advised against wearing masks at the start of the COVID pandemic
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Very interesting, looks like they are learning the lessons from the [thyroid cancer](https://www.iarc.who.int/wp-content/uploads/2018/07/pr246_E.pdf).
When the carpet bombing of everything suspicious might not be better than what you’re trying to prevent.
The key is not the screening, it’s what you do with the result.
We need to learn to be wise enough to be told “yes, we found something, but it’s better not do anything about it”.
For thyroid, they even had to, in some cases, [stop calling it cancer](https://www.cancertodaymag.org/fall2016/thyroid-tumor-gets-new-name/) because people would freak [out](https://pmc.ncbi.nlm.nih.gov/articles/PMC9633223/).
It’s very refreshing to hear dispassionate discussion that can go beyond the black and white.
Happy Movember to all anyway!
And here come the bots to explain why *not screening for cancer* is a good thing. Somehow. Likely with the use of biased numbers and cherry picked statistics from an inherently biased source.
So my mate found out he had prostate cancer by random blood test for something else.
They decided it’s not worth operating on but keep an eye on it every year.
Soooooo
I wonder how many of us are walking around with it? If they diagnose it wound they have to monitor it every year to? Would you have to tell your work place? Life insurance? Health insurance?
Fair enough King Charles gets routine screenings though.
12000 men a year dying – but hey lets not make anyone anxious – lets just wait until there are symptoms, blood in your pee maybe and its too late – then we will “Leap into action”
As my dad died at 66, no prior symptoms until he had shoulder pain, by which time it had metastasised into his spine. Specialist explained he probably had, had it for 5 years and compared it to a dandelion – and spores floating into other parts of the body so pardon me if I don’t much fancy living with cancer inside me as, on the balance of probability, I might be ok.
So I feel incredibly bitter about my father dying so early, how men are blamed for “not going to the doctor” but when they do support isn’t there. I insist on PSA checks annually but doctors will do anything to avoid a manual test. You may all be medical professionals on here but heres how it seems from a male who is in a higher risk category whether you like it or it or not. The UK NHS is a Gynocentric organisation which cares much less about male health than female health and it can only be concluded men don’t matter as much as women.
I have prostate cancer. It’s ok, it gets checked and medicated. I wasn’t screened, I was just man enough to go to the doctors when I noticed something was amiss with peeing.
I’ve just watched Colin McFarlane on sky news campaigning for men to get to tested, presumably off his own back. He seems to be able to explain it in a clearer more relatable way than I ever heard before – which is an astonishing thing to say – but worth checking out
I was sadly expecting this. By the time they have symptoms it’s often too late which is why testing is so important. So the men who DO have high risk prostate cancer are just left to watch it grow and hope they kick the bucket from something else in 5 years instead? I find it absolutely shocking that they don’t even want to invite men who have a family history or high risk due to ethnicity. All these “studies” really can’t work out that a man is at higher risk if his brother, dad and uncle died of prostate cancer-really?! I think I’ll take the opinion of the campaigners and charities who think testing is a good idea over the doctors who have vested interests.