Writing as a man aged 66, you’d think I’d be concerned about prostate cancer, one of the current health hobby horses. In a way I am, but I also have an aversion to being told to worry about one thing after another, and my concerns also include the side-effects of treatment which are consistently overlooked in all sorts of contexts. I have seen what has happened to friends and relatives who have been diagnosed with prostate cancer.
When I watched a Hannah Fry Horizon documentary about her own cervical cancer experience, the side-effects of her treatment and the research she’d pursued, one of the most alarming points raised was that the risk of life-changing side effects from chemotherapy seemed to be somewhat higher than the risk from breast cancer. She asked “are we over-medicalising” cancer?
Now it seems that a major study running over 15 years has questioned the whole process of prostate cancer screening.
The Telegraph has the story:
Prostate cancer screening is likely to do more harm than good, experts have warned, after a 15-year trial showed one in six flagged cases was wrong.
The largest study to date investigating the PSA (Prostate-specific antigen) blood test, which is used as a screening tool in some European countries, found it had a small impact on reducing deaths, but also led to a worrying level of over-diagnosis.
In some cases, it missed early detection of some aggressive cancers.
Researchers from the universities of Bristol, Oxford and Cambridge, invited more than 400,000 men aged between 50-69 for screening, with just over half receiving a PSA test.
After following up for 15 years, nearly seven men out of every 1,000 in the group invited for screening had died from prostate cancer, compared to nearly eight men out of every 1,000 who had not been tested.
The results of the trial show that an estimated one in six cancers found by the single PSA screening were over-diagnosed leading to unnecessary treatment of tumours that would not have caused any harm in someone’s lifetime
The treatment of prostate cancer may cause physical side-effects including the possibility of infection following a biopsy, erectile dysfunction and bladder and bowel problems.
The key problems seem to involve missing the more aggressive cancers while subjecting other men given a positive diagnosis to treatment that may be unnecessary and causes more harm.
Dr. Neil Smith, GP for Cancer Research U.K. and GP Lead for Lancashire and South Cumbria Cancer Alliance, said: “With prostate cancer causing 12,000 deaths in the U.K. every year, we completely understand why men want to know if they have the disease, even when they don’t have symptoms.
“However, this research highlights that a PSA test for early detection can do more harm than good – it’s simply not accurate enough and can lead to some men having tests and treatment that they don’t need.”
Definitely worth reading in full.
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