 |
 |
I read it in todays paper with some sadness. Perhaps Wilson and Junger need an additional or overriding criteria about impending elections. Adrian Freeman GP -----Original Message----- From: Evidence based health (EBH) is the integration of individual knowledge [mailto:[log in to unmask]]On Behalf Of Toby Lipman Sent: 25 March 2001 09:30 To: [log in to unmask] Subject: Prostate cancer screening? It may be just the clocks going forward, but I'm sure I heard on the radio that "men will be able to attend their GP to be screened for prostate cancer". I was not aware of any change to the advice given by the UK National Screening Committee in 1997 that the low specificity of the test available (PSA) and the lack of consensus on appropriate management of prostate cancer, particularly in its early stages, meant that a screening programme for prostate cancer would fail to meet WHO criteria (Wilson and Jungner, WHO paper no 34, 1968). Is there new evidence that prostate cancer screening meets Wilson and Jungner's criteria (below)? -The condition has a recognisable early phase and early treatment can be shown to improve prognosis -Effective treatment is possible and available -The test for the condition should be relatively simple, not harmful and acceptable to the patient -The test should achieve a balance between false positives and false negatives which is related to the severity of consequences of wrong diagnosis both for the health care system and the patient -Screening must be sustainable once introduced and not just part of a limited specific initiative Toby -- Toby Lipman General practitioner, Newcastle upon Tyne Northern and Yorkshire research training fellow Tel 0191-2811060 (home), 0191-2437000 (surgery) Northern and Yorkshire Evidence-Based Practice Workshops http://www.eb-practice.fsnet.co.uk/