Quick, go get your March 26, 2009 issue of the New England Journal of Medicine. I’ll wait…
Got it? Okay, flip to the two articles on prostate cancer screening. See them? No? Okay, perhaps you’ve accidently picked up the Ladies Home Journal. I know people get confused. For the last time:
New England Journal of Medicine = one of the most respected medical journals in the world.
Ladies Home Journal = a magazine (though I swear I was in a seminar not so long ago and the instructor quoted an article from LHJ as if it were peer-reviewed).
That’s okay…cut out the coupon for Birdseye veggies in LHJ while I tell you what the studies say in NEJM.
Two large clinical trials, one American and one European, assessed whether screening for prostate cancer is effective. Both studies show that screening had little or no effect in reducing prostate cancer deaths. No tiny little studies were these either. 77,000 men in the American study and 182,000 in the European study.
These numbers are huge. I can’t even imagine how someone could manage a clinical trial with that many people. I once tried to organize a Pez dispenser collection and gave up when there were too many to keep track of. 182,000? Actual people? Damn.
So, the American study found no reduction in prostate cancer deaths after all the men had been tracked for seven years and two-thirds had been followed for 10 years.
The Europeans found a modest reduction in deaths after nine years but a high risk of needless treatment given. In fact, half the men diagnosed with prostate cancer would not have had clinical symptoms during their lifetimes. The European research suggests that roughly 50 cases of prostate cancer found through a screening program would need to be treated to prevent a single prostate cancer death.
The amount of unnecessary cancer treatment that has occurred in the name of the PSA prevention is sickening. Certainly these studies are not the final word and you should discuss screenings with your doctor. And since both studies will continue to follow the men, it remains possible that the United States study will eventually find that screening can reduce the prostate cancer death rate.
I wouldn’t hold my breath.
In the meantime, no one is gonna touch my prostate…unless, you know, I know them really, really well.