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Another view/study about when to screen for PCa

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Posted 4/17/2013 1:51 PM (GMT 0)
Spotted this report on the BBC about the suggestion that screening the 45-49 age-group might have positive outcome. Note that it says that there is currently no programme for routine screening for PCa in the UK.

www.bbc.co.uk/news/health-22164449

Never quite sure how to reconcile the two ways things gets explained in these type of reports. As on the one hand it says that to save one life you have to treat 48 other men, while on the other is says that in the study, 1,369 of the men had prostate cancer, 241 had advanced disease and 162 died from it.

Alf

Post Edited (English Alf) : 4/18/2013 3:32:49 AM (GMT-6)

Posted 4/17/2013 3:01 PM (GMT 0)
thanks Alf.  pretty obvious conclusion.  it's not the screening that's the problem.  DOH cool !

ed

 

Posted 4/17/2013 3:35 PM (GMT 0)
Alf,

If I read your numbers right 162 deaths among 1369 is an overall prostate cancer specific survival rate of about 88 percent. Saving one guy in 49 means that screening reduces that mortality rate by just over two percent.

This means that if you look at those 49 guys -- 48 treated without changing their outcome plus the one saved -- you will find that --

one was saved by treatment,
42 were treated unnecessarily (would live w/o treatment),
and six were treated unsuccessfully (will die no matter what you do).

The reason the numbers don't seem to add up for you is probably because you forgot about those last six guys who can't be saved.
Posted 4/17/2013 3:41 PM (GMT 0)
If the other 6 died from PCA, shouldn't they included with the initial 1. Unless they in fact died of something else? Statistics are very weird and fluid tho.
Posted 4/17/2013 7:09 PM (GMT 0)
Thanks Alf for the link. An interesting twist is the conclusion of this (very confusing) study and something we have not heard before - not in these words:

Screening too young - below 45 years of age - detected too few deadly cancers.

And delaying screening until after a man's 50th birthday missed too many.

Screening men at the age of 45-49, however, spotted nearly half (44%) of the cancers that went on to be deadly.


From what I am reading, the other significant predictor group is 50-55. Also, the authors quote their previous study that says PSA concentration at 60 was strongly relevant to the risk of death at 85.

My take on this, very important to have the first PSA at 45-50 and if it is above median 0.68 ug/mg keep a close eye, if it is below relax, but not entirely, as even some guys below the median value at 45-50 went on to develop metastatic cancer after 25 yrs. And continue doing screening till 70. I guess nothing we didn´t already know. :)
Posted 4/18/2013 9:32 AM (GMT 0)
Special lady
You spotted the part of the study that I thought was interesting.
IE it seems there may be a window of opportunity of some sort for guys aged between 45 and 49 where testing can make a bigger difference than in other age ranges.
Now if they can also find a test to spot which of those guys have got the aggressive PCa then there could be a win-win situation by not over-treating those not at risk and by hitting the at-risk guys with effective solutions.

Peter - thanks for the added input. (I had my nephew staying a few weeks ago and he is a very clever at math, but he lost me very early on when we started talking about statistics luckily he is married to someone who is also a maths expert!)

Alf
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