Sadly, the point of the PSA screening program is not what we think it is.
Really, it allows the Goverment to say that they are doing something for
men's health, in the same way that cervical and breast screening are claimed
to help women's health. All three program's are really political initiatives
designed to make voters feel positively inclined towards politicians.
It is apposite that the PSA screening information should come out
simultaneously with papers in the BMJ dealing with the (non-)effectiveness
of PSA screening in Seattle & Connecticut where despite a massive increase
in radical prostatectomy and radiotherapy in Seattle there was no effect on
prostate cancer related death relative to Connecticut where prostate
screening had not been practiced.
The BMJ editorial in the same issue also was critical in stating that the
function of screening is actually to convert healthy individuals into
patients [at great cost]. with little evidence of benefit...
TIM
****************************************************************************
*********
Prof. Tim Reynolds,
Clinical Chemistry Department,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFORDSHIRE,
DE13 0RB,
UK.
tel: 01283 511511 ext. 4035
fax: 01283 593064
email: [log in to unmask]
alternative email for the all too frequent occasions when the NHS email
connection doesn't work:
[log in to unmask]
****************************************************************************
**********
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-----Original Message-----
From: Dr S Walker [mailto:[log in to unmask]]
Sent: 08 October 2002 17:07
To: [log in to unmask]
Subject: Prostate Cancer Risk Management Programme
I received a letter from the DoH on 30.09.02 stating that every GP in
England had been sent a resource pack (on 23.09.02) to help them in
counselling asymptomatic men requesting serum PSA testing. They also kindly
supplied me with one of the resource packs. The info gives empirical serum
PSA cut-offs for referral to urologists and these are lower than my current
age-related referent ranges (particularly for the 70 and overs). I
contacted our urologists, radiologists and histopathologists - none had been
sent this info or knew about this government initiative. We are not aware
of ANY extra funding to support the initiative either. Is anyone else? The
ACB mailbase has had nothing on this. Is everyone aware of this?! I've been
away on leave for some weeks so perhaps I missed all the debate? Is every
english lab changing to the stated cut-offs immediately?
These are:- age 50-59 PSA 3.0 ug/L or higher, age 60-69 PSA 4.0 or higher
and age 70 or above PSA 5.1 or higher. I guess that if you are currently
using a single cut-off of PSA 4.0, you and your colleagues will not see an
increase (maybe even see a fall) but we will see potentially an increase of
some 340 referrals/biopsies/follow ups p.a. My own workload wont'
really be affected but joined up NHS and sharing of information would be
nice! The letter also stated that by 31.03.03 laboratories will be using an
assay with calibration traceable to the 1st IRP for PSA andhaving equimolar
recognition of both free and complexed PSA. Interested to hear anyone else's
views. Dr Sue Walker, Laboratory Medicine, Salisbury District Hospital,
UK, SP2 8BJ
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