NYT: PSA saves few lives

[Gfunk6]

http://www.nytimes.com/2009/03/19/health/19cancer.html

Here is the NEJM article it references: http://www.nytimes.com/2009/03/19/health/19cancer.html

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[Charles_Carmichael]

Thanks for the article. You accidentally posted the NYTimes article again instead of the NEJM one in your second link. Here are the links to the two studies the article mentions:

The American study:
http://content.nejm.org/cgi/content/full/NEJMoa0810696


The European study:
http://content.nejm.org/cgi/content/full/NEJMoa0810084

 

[medgator]

These studies stress OS but neglect to mention the local/distant morbidity associated with untreated prostate cancer. It's a shame the NYT article doesn't bring this up.

When the post-prostatectomy XRT studies first came out, the data for OS wasn't there but the evidence for decreased hormonal therapy usage and decreased metastatic disease was. An argument can be made for treating prostate cancer even if there is not an impact on survival. The morbidity (both physiologic and psychosocial) of bone metastases and that of androgen deprivation in men should not be trivialized, let alone be completely ignored.

 

[qwert]

Until indolent and aggressive prostate Ca can be reliable distinguished, treating early localized disease makes sense in effort to avoid hormonal therapy.

 

[Ursus Martimus]

It's a shame the NYT article doesn't bring this up.

Clearly the NYT has targeted radiation and things related as someone there is clearly unhappy with the lack of healthcare reform. That being said, the true shame comes from the editorial staff and reviewers at NEJM.

"Rates of screening in the control group increased from 40% in the first year to 52% in the sixth year for PSA testing and ranged from 41 to 46% for digital rectal examination." '

That is clearly some significant contamination, when on an intention to treat analysis jacks up everything. I mean really, they might as well have enrolled 50% women and said "see PSA screening doesn't provide any benefit"