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TR>In a message dated 15/09/96 06:02:01, David Jobson writes: TR>>But where is your validated protocol to show that doing a PSA TR>>on patient with outflow symptoms makes one halfpennyworth of TR>>difference either? It's become the norm to do it, but .... Trefor replied TR>The protocol I use was sent to all Sheffield GP's by the urologists a couple TR>of years ago. They suggest PSA if symptomatic and over a certain age (sorry TR>can't remember cut off, will get detail if you wish). I don't know how they TR>came up with the ideas but could find out if you want, A group looked at it locally and decided that there was no good evidence that doing PSA routinely with obstructive symptoms made any difference as we don't know how, or if, to treat early cancerous disease. Big trials going on in USA I gather with radical prostatectomy etc.. If you can't be sure that treating a disease earlier than it would normally present is better than waiting till it presents then it shouldn't be screened for, according to the Wilson criteria. Amazing how different areas of the same NHS keeps inventing different wheels :-) ______________________________________________________________ Dr. David Jobson The Surgery, Main St Surgery Tel +44 (0)1728 830526 Leiston Surgery Fax 832029 Suffolk Home Tel 831100 IP16 4JG email [log in to unmask] * SLMR 2.1a * %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%