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"Screening Saved My Life" — a popular sentiment, but how true?

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Posted 10/27/2011 3:17 PM (GMT 0)
I remember well your call for reason and civil discussion, Casey, and I think that has been the norm in these threads.

Obviously, you and I are not in complete agreement, but anyone can appreciate your thoughts and insights, and the whole spectrum of opinion should be out there for consideration.

I've never understood the mindset that says, "I don't like what you're saying, so shut the hell up."

Posted 10/27/2011 4:55 PM (GMT 0)
If I live to be 70 then PSA saved my life. If i die of something else in the next 20 years then I probably could have for gone the surgery. I hedged my bet I plan on being around for a while my grand parents lived until their mid 90's. My mother is in her mid 70's and still lives on her own. So waiting and seeing was not a good bet for me. By the way I was diagnosed at 49.  
Posted 10/27/2011 5:46 PM (GMT 0)
Casey,
What kind of information about PSA testing do you think Dr. Welch supports?
Where is an unbiased inform consent form that would help men decide if they want to be tested or not? Do you really think that a 15 minute appointment with a physician and his personal opinion about this issue is realistic?

Why I said what I said is based on Dr. Welch and his Dartmouth team. They invariably exaggerate over treatment rates for a purpose as they have no explanation for the reduction of PCa mortality in this country since the introduction of PSA testing.

H. Gilbert Welsh. MD, MPH
Dartmouth Professor of Medicine and Community and Family Medicine
Co-director, VA Outcomes Group.

He has said, written and influenced against PSA testing:

"We've seen it before. Twenty years ago another simple blood test was introduced. Twenty years later over 1 million Americans had been treated for a cancer that was never going to bother them."
Even though this represents 25% over treatment, he reports the number to be 60%. Go figure?

Wrote a book: "Over-Diagnosed" He believes that 60% of the men diagnosed and treated for prostate cancer are over treated as they would never be afflicted by the disease. Go figure? Crystal ball diagnostics?

PSA testing in the Veterans Health Administration system following
publication of the ERSPC and PLCO studies. They found
that PSA testing declined by 5.5–9.1% (2.2–3.0 absolute percentage
points) depending on the age group studied. Way to go! Saved some over treatment...

He is part of the Dartmouth team that opposed the US stamp supporting PCa awareness.

Given all these, I still believe that PSA saved my life, considering Dr. Welch's propensity to not recognize the value of PSA testing in reducing PCa mortality in the US and around the world.

RalphV
Posted 10/27/2011 6:03 PM (GMT 0)
Ralph,
Turning the tables, and using Welch's crystal ball data, that means he suggests that 40% men were NOT over treated. How we can derive that PSA screening does not save lives is preposterous even from this Welch's own words.

The numbers of lives saved are debatable. I think both sides of this USPSTF spurred argument agree that to some point there are lives being saved by PSA screening. It's simple, one side does not feel enough lives are being saved and therefore for the social good it's ok to lose those patients.

You and I can speak for the side that knows that we were fortunate to be tested. The argument from the other side seems to feel that to prevent ED and incontinence outweighs lives like ours. This as opposed to spending some money to educate men and doctors better.

My position is completely unchanged. The diagnosis of prostate cancer through screening is not the problem. What we do with that data requires careful education and decision making and we need doctors to be less gung ho in their "right after diagnosis" recommendations.

Tony
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