14 year prostate cancer screening study ~ 50% improvement in mortality

First my apology to Tatt2man. He posted this study before me, but I am posting it again because of its significance and to add my commentary.

A Swedish study of 20,000 men over a 14 year period found that screening dropped prostate cancer specific mortality by 50% at year 14. So much for that silly 1 in 48 number at year nine posted in the New England Journal of Medicine last year.

Missed the mark by a mile as I like to say...

Being a person who was diagnosed with advanced disease at age 44, I found it amazing that no long term studies were available for prostate cancer. The typical study is considered "mature" at ten years and you'll see lot's of studies showing results at even less intervals. My suggestion ~ throw them out. Prostate cancer is a 20 year or longer disease. When you start extending study terms as this one does, you get totally different results.

Here is the Infolink article:
prostatecancerinfolink.net/2010/07/01/new-swedish-data-suggest-that-screening-does-lower-mortality/

Screening saves lives!

Tony

Tony - no worries - there are more fluent that me in the various studies and such - just wanted to post the link as described - it appears to be the same link john t is talking about - but he has reversed what I read as "decrease in mortality" - to increase... here is a copy of the email sent...
............
The "New" Prostate Cancer InfoLink Social Network
A Service of Prostate Cancer International
A message to all members of The "New" Prostate Cancer InfoLink Social Network

There's a new report from a Swedish study involving 20,000 men followed for 14 years suggesting that biannual PSA testing can lead to a 50% reduction in prostate cancer-specific mortality.
................................
BRONSON

Well, I don't know a lot about this stuff, but it just stands to reason, or logic, that regular screenings have to have some statistical improvement. It just makes no sense that the men on this site who have had treatment for their PC, are no better off than if they had not been treated at all.

It is kind of hard also to compare men who had screenings with men who could have been diagnosed and treated who didin't get screened and died. Once they are dead, kind of hard to follow up on them.

Maybe I'm just thinking too much about this stuff !

Bronson,
I'm referring to a study posted 4 days ago.
http://prostatecancerinfolink.net/2010/06/28/prostate-cancer-mortality-in-scandinavia-1965-to-2006/

This study shows no difference in mortatlity over the last 40 years.
So which study are we to believe?
JT

Everytime I wrap my mind around a conclusion it seems that the target has been moved. I'm 51, had my RP 6 weeks ago. My 3+4 went to 4+5 with titiary 5, pos margins. Seems logical to have RT.. and will be talking with Rad Onc in a week+-. I REALLY am concerned about the effects of that radiation on my quality of life - the 3-5 years down the road when the damage from that radiation starts taking effect. I've spoken to doctors/oncologists who have no personal interest in my specific case, and they speak of it as "they got your cancer, now radiation is just going in and cleaning up the leftover cells... we find radiation VERY effective at doing this, and you should be fine". One said in retrospect (pathology), they wouldn't have removed the prostate, they would have gone radiation???? But then I hear how there is really no conclusive evidence that X works better than Y.... NOW better than LATER... I also got the same "Ballpark" answer when I asked 2 different urologist "what if I dont treat at all, how long would I survive from the disease?"... Both said "Probably 10 years". And I say to myself (and my wife) HECK, if I can hope for 10 years, and nobody can show me that the radiation can extend that window, why the help put myself through that radiation, further diminishing my quality of life?

And thoughts? I Dont mean to steal this thread if thst's where this ended up, but I am concerned and have to make some decisions.. and it DOES ultimately lead back to the screening issue - AS IN Did it / Does it - really matter if you knew you had Prostate cancer if the only thing proven about the treatments is they complicate the quality of your life?

postop ended his post with these words:

"The conclusion I'd draw from this, if you are over 70, don't get screened. Younger than that, the studies don't really prove that much benefit, but it seems reasonable if you're in your 50s in good health, there is likely a significant benefit. But early prostate cancer is slow growing, so, if you've got it, you may well not die from it, and if you radiate it or have surgery, there is some possibility that you may not be saving your life".

I don't think I could disagree with your conclusion any more than I do. If a man is 70, comes from a non-PC family, and has/had family members living into their upper 80s or even 90s, then if they were dx with PC, there are still treatments for dealing with it appropriate for their age, and might assure them they could live out their normal life time.

"Younger than that, the studies don't really prove that much benefit" - how could you draw that conclusion. For most men, detection is what leads to treatment which leads to saving their lives. If they weren't screened, they wouldn't know and wouldn't be treated, and pc cases would advance, and men would die.

Then other myth is that PC is slow-growing. That is not always true. We have a large segment here just in our small world at HW that are Gleason 7 and above, including a fair number of Gleason 8 higher cases. Left untreated, these men would very well die of PC.

Then you end by saying, paraphrase, that even if you have surgery or radiation, you may still die. So which way is it?

You didnt post your stats this time, so I can't remember your particulars, to see if screening, dx, and treatments have helped you with ayour PC journey and what your own prognosis is like.

This is why I don't like all the analysis of well meaning studies, that the average person can't prove or dis-prove the numbers. Its easy to talk about the meaning and value when its just numbers on a piece of paper. I put PC not at the report level, or nanograms, but at the person level, the human level, one patient at the time, and the value of his life as an individual trying to survive this thing called PC.

No disrepect to your post in any personal way.

David in SC