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A "considerable"
number of men over age 60 diagnosed with prostate cancer after
taking the prostate specific antigen (PSA) test are receiving
treatments for a disease that never would have affected them
in their lifetimes, according to researchers.
The researchers
at the Fred Hutchinson Cancer Research Center in Seattle said
a statistical analysis of prostate cancer incidence showed
that approximately one in six white men diagnosed with prostate
cancer -- and one in three blacks -- never would have experienced
any symptoms of the disease.
"The
observed trends in prostate cancer incidence are consistent
with considerable overdiagnosis among PSA-detected cases,"
the researchers reported in the Journal of the National Cancer
Institute. "Overdiagnosis was defined as the detection
of prostate cancer through PSA testing that otherwise would
not have been diagnosed within the patient's lifetime."
The findings
seem certain to add to the long-running controversy over the
value of the PSA test. While the test can detect prostate
cancer at an early stage when the cure rate is high, it also
can lead for some older men to treatments -- possibly unnecessary
-- that can result in such side effects as impotence and incontinence.
In order
to better understand the magnitude of this problem, the researchers
developed a computer simulation model of PSA testing and subsequent
prostate cancer diagnosis and death from prostate cancer among
a hypothetical cohort of two million men who were 60–84
years old in 1988.
They said
the results of their study suggested that the majority of
prostate cancers diagnosed by PSA screenings between 1988
and 1998 would have ultimately resulted in symptoms that would
have been diagnosed by a doctor.
But, they
concluded, the prostate cancer detected by PSA tests in "at
most 15 percent in whites and 37 percent in blacks" would
otherwise have done undetected.
Source:
Prostate Cancer
Week of July 7, 2002
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