Dr Tracey McDonald AM PhD FACN, Professor of Ageing, 2007
Dear colleagues, please have a read of the latest research on prostate cancer screening (Cochrane, 2006). (https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004720.pub2/abstract)
After reading through this Cochrane review on the efficacy of screening I thought the information it reveals is sufficiently important for me to alert you about it.Essentially it finds that screening has little to no effect on mortality except for younger men and even then, only a small effect on mortality.More importantly, the risks of trauma and medical over - servicing resulting in incontinence, erectile dysfunction, infection and deep depression are significant.
This is important to know and incorporated into our practice at a time when all men are being urged to have the screening done and made to feel bad if they choose not to.Some have even been accused of self - neglect by their health practitioners and family members – and some radio announcers - if they do not want to have the screening done. What men really need is genuine advice that is balanced and evidence - based to help them to choose… and then they are entitled to our support for whatever their choice may be.
NOTE: I sent round another blog to colleagues in 2013:
PROSTATE CANCER SCREENING: An update on my 2007 announcement:
The Cochrane team have updated their study by re - running their search of published research on this topic(https://med-fom-urlgsci.sites.olt.ubc.ca/files/2007/06/P-ca-screening.pdf). They looked at five large studies involving a total of 341 351 participants. Among the findings is that “Harms of screening included high rates of false-positive results for the PSA test, over-diagnosis and adverse events associated with transrectal ultrasonography guided biopsies such as infection, bleeding and pain”. They concluded that “Prostate cancer screening did NOT significantly decrease all-cause or prostate cancer-specific mortality in a combined meta-analysis of five RCTs; and that any benefits from prostate cancer screening may take >10 years to accrue; therefore, men who have a life expectancy of around 10-15 years should be informed that screening is NOT beneficial and could harm them”.
Let’s get out there and support our men with evidence - based advice and support them in their efforts to be healthy and able to enjoy a quality of life without unnecessary interventions.
Ilic, d., O’Connor, D., Green, S. & Wilt, TJ. (2011) BJU International, 107, 882–891.doi:10.1111 / j.1464 - 410X.2010.10032.x