Early detection of prostate cancer: serendipity strikes again
Article Abstract:
One-quarter of all cases of prostate cancer actually may have been detected by chance rather than by diagnostic tests. The digital rectal exam and prostate-specific antigen (PSA) blood test, if suspicious, are usually followed by prostate biopsy to definitively diagnose cancer. A review of studies found that sometimes noncancerous conditions cause abnormal test results, then lead to biopsies that find cancers too small to have affected the test. About 1/4 of cancers found after either diagnostic test appear to be by chance. The detection of small tumors by chance may lead to overly-aggressive treatment and may not improve clinical outcomes.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1997
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Controversies in prostate cancer screening: analogies to the early lung cancer screening debate
Article Abstract:
The history of screening for lung cancer with chest X-rays illustrates the dangers of instituting a diagnostic test before there is good evidence that it will reduce the incidence of disease. Chest X-rays were encouraged in the 1950's but clinical trials in the 1970's led the American Cancer Society to discourage the practice. Many physicians are now encouraging the use of diagnostic tests for prostate cancer before clinical trials are done to show their effectiveness at reducing the incidence and mortality rates of the disease. This may be premature until clinical trials demonstrate their effectiveness.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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A 73-year-old man with symptomatic benign prostatic hyperplasia
Article Abstract:
About 40% of men in their 70s will experience benign prostatic hyperplasia (BPH). This condition occurs when the prostate gland enlarges and presses on the urethra. This can cause urination disorders such as inadequate bladder emptying and frequent urination. Diagnostic techniques include measurement of urinary flow rate, digital rectal exam, neurologic exam and measurement of prostate-specific antigen. Men with mild symptoms may need no treatment. More severe symptoms can be treated with finasteride and an alpha blocker. Surgery can be very effective especially if less invasive methods can be developed.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1997
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