This weeks New England Journal has an article on this very subject in their
new "Clinical Practice" section.
Barry MJ. Prostate-Specific-Antigen Testing for Early Diagnosis of Prostate
Cancer. New Engl J Med  2001; 344(18): 1373-1377
http://www.nejm.com/content/2001/0344/0018/1373.asp


Joe Begley
Poole Hospital

----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, May 08, 2001 8:58 AM
Subject: Re: Sunday Times article on Prostate Screening


> One difficulty with screening for prostate cancer is that no one really
knows what to do with some results: THere has been a massive increase in
prostate cancer in the US where PSA has really taken off - but minimal
change in the death rate. This is thought to be because many cases of
prostate cancer that patients would die WITH rather than OF have been
identified, resulting in lots of radical prostatectomies, much morbidity but
minimal benefit.
>
> Before we begin prostate screening we need to be certain we will provide
benefit: there is significant evidence that shows that cervical and breast
cancer screening don't actually help - they just identify who is going to
die a few months earlier allowing them to die longer than 5 years after
diagnosis, thereby counting as a survivor in the stats!
>
> TIM
>
> **************************************************************************
> Prof. Tim Reynolds,
> Clinical chemistry Dept.,
> Queen's Hospital,
> Belvedere Rd.,
> Burton-on-Trent.
> tel: +44 (0) 1283 511511 ext 4035
> fax: +44 (0) 1283 593064
> email: [log in to unmask]
>  [alternative email for when all too frequently NHS Net isn't working
[log in to unmask]]
>
>
> -----Original Message-----
> From: c=GB;a=NHS;p=NHS NATIONAL
> INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
> Sent: 07 May 2001 00:44
> To: c=GB;a=NHS;p=NHS NATIONAL
> INT;dda:RFC-822=ACB-CLIN-CHEM-GEN(a)JISCMAIL.AC.UK;
> Subject: Re: Sunday Times article on Prostate Screening
>
>
> Dear John,
> Sorry I am just now responding but I have been on holiday.
>
> I have been led to understand that if a person has a PSA of .05 and
> subsequently develops prostate cancer his PSA results will most probably
> increase and eventually rise above 4.0 and even go higher as the cancer
> develops. Please advise as to why you think "The merits of using PSA as a
> screening test for prostate cancer are questionable to say the least."
> Especially since early detection is important to successful intervention.
>
> Warren C Stuart
> Director, The Phoenix Foundation
> http://www.bioport.org
> ----- Original Message -----
> From: "John O'Connor" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, March 25, 2001 5:14 PM
> Subject: Sunday Times article on Prostate Screening
>
>
> > For the non sunday times takers amongst list group members.
> >
> > There was an interesting front page article entitled ' NHS plans
prostate
> > screening'
> >
> > A snippet of the article is reproduced below. The full atrticle can be
> > viewed at www.sunday-times.co.uk.
> >
> > 'Under the scheme, Informed Choice, a patient can ask a doctor for a
> > Prostate Specific Antigen (PSA) test. First he will be given an
> information
> > pack explaining the possible consequences and options. Most positive PSA
> > test results are difficult to interpret because many are caused by
benign
> > conditions. A positive result can be checked only by using a biopsy
which
> > can itself be risky. '
> >
> > The merits of using PSA as a screening test for prostate cancer are
> > questionable to say the least. But the implication of the article is
> another
> > huge hike in the PSA workload we already have to tackle. Do any of you
> have
> > a copy of the information pack intended for patients, or information
being
> > supplied to GPs for such a screening program to be undertaken?.
> >
> > It would be interesting to resume the debate in the light of this
article
> > and perhaps summarise it on the ACB website (Thanks in anticipation, to
> Ian
> > Godber our ACB webmaster). And if anyone has the patient info pack, to
> place
> > this on the document exchange forum so at least we are all aware of how
> the
> > general public view the validity of the test.
> >
> > John O'Connor