> For many cancers, the authors argue for a greater focus on the early detection of the disease rather than on prevention of its occurrence. If misinterpreted, this position could have serious negative consequences from both cancer research and public health perspectives.
> In principle ... nearly half of all cancer cases worldwide can be prevented
I am not sure what to take from this article. Lung cancer prevention is already in progress. At the same time prostate cancer has even higher mortality (for non smokers) and preventive checks are not even covered by most insurance companies.
I believe that it's something elderly men commonly die with rather than of (especially allied with medication to suppress the tumour) but it's not a universal truth either.
There is a great difference between the incidence of prostate cancer and the death rate from it. Prostate cancer is currently diagnosed in 15 to 20% of men during their lifetime, but the
lifetime risk of death from prostate cancer is only 3%. Source: European prostate cancer guideline (page 45): http://www.uroweb.org/gls/pdf/09%20Prostate%20Cancer_LRLV2.p...
> Tumour grade is clearly significant, with very low survival rates for grade 3 tumours. Although the 10-year cancer-specific rate is equally good (87%) for grade 1 and 2 tumours, the latter have a significantly higher progression rate, with 42% of patients with these tumours developing metastases (Table 8.4). Patients with grade 1, 2 and 3 tumours had 10-year cancer-specific survival rates of 91%, 90% and 74%, respectively, correlating with data from the pooled analysis (49) (LE: 3).
Wherever one dies 'with it' or 'because of it', this cancer might progress into metastases, and it brings higher mortality rate.
You can become old with localized prostate cancer. You have to make the choice if you want to live with some uncertainty (the cancer could progress into metastases) or to get treatment now. The downside of treatments, like surgery and radiation, is the risk of becoming impotent and/or incontinent.
The council recommendation on cancer screening for the European Union accepted in 2003 states that PSA testing for prostate cancer, though promising, does not meet the criteria of having proved to decrease the cancer-specific mortality, or well known and acceptable benefits and risks, as well as cost-effectiveness. Therefore, prostate cancer screening is not recommended. The statement emphasizes the importance of the randomized trials and specifically cites the ERSPC in this respect.
This position is consistent with the recommendations of an expert panel organized by the World Health Organization (WHO) and the International Cancer Union, which stated that sufficient evidence showing the benefits of prostate cancer screening in terms of mortality reduction is still to emerge. Therefore, offering screening as part of health care policy can not be recommended without further evidence.
Similar conclusions about withholding screening due to lack of evidence have also been reached in assessments of the U.S. Preventive Services Task Group and the U.S. National Cancer Institute.
Nevertheless, screening does take place even if it is not part of the policy. This is done on the basis of judgment and the responsibility of individual physicians and their patients, who may in some circumstances, regard the possibility of benefit as more important than lack of demonstrated effectiveness.
The PSA test, which can give an early indication of prostate cancer, is available to you
if you want to be tested. However, experts disagree on how useful the PSA test is. This is why there is a lot of research and why there is no national screening programme for prostate cancer in the United Kingdom (UK).
You need to:
> screen 1410 men
> then take a biopt from 340 of them
> then diagnose 82 men with prostate cancer
> to save 1 man from dying from prostate cancer
> In principle ... nearly half of all cancer cases worldwide can be prevented
I am not sure what to take from this article. Lung cancer prevention is already in progress. At the same time prostate cancer has even higher mortality (for non smokers) and preventive checks are not even covered by most insurance companies.