There has been a decline in the number of men diagnosed with prostate cancer in the United States including the number of men who submit for early screening. This is according to two new studies published in "The Journal of the American Medical Association" on Nov. 17, Tuesday.
The less effort exerted by men to be screened is causing worry to healthcare providers as this may pose health risk to men who have no idea they suffer from cancer. This decline, both screening and incidence, "could have significant public health implications," according to the authors.
American Cancer Society reveals that this year, nearly 221,000 cases and over 27,000 deaths are predicted. The study authors, in addition, stated that the impact of these changes in men's perception towards cancer and screening will be seen soon.
The decreasing trend was, however, noted in 2012 after the US Preventive Services Task Force (USPTF) recommended against regular prostate-specific antigen (PSA) screening in men more than 50 years old. They explained that these changes were made since not all tumors detected can cause harm to the body; thus, overall health is instead challenged because of the unnecessary surgery and treatment prescribed.
The agency, for instance, reported that of those who are diagnosed with prostate cancer following a PSA testing, 90 percent of them are given early treatment like surgery and radiation. "With PSA testing, we often detect cancers that don't need to be treated - clinically indolent, meaningless cancers," said Vanderbilt University Medical Center's chairman of urologic surgery Dr. David F. Penson.
Statistics, which supported the conclusion of obtaining fewer tests, revealed that in every 1000 men, one man dies one month post-operatively, around 10 to 70 suffers from severe complications and between 200 and 300 will live the long-term effects of early treatment.
About 5 in 1000 men die within a month of surgery, between 10 and 70 of 1000 will survive some type of serious complication, and 200 to 300 of every 1000 will have some type of long-term effect as a result of the early treatment - statistics that led the agency to suggest fewer tests be done as a protection for men who do not need treatment. "Certainly, physicians have been overly aggressive in their approach to prostate cancer screening and treatment during the past 2 decades, but the pendulum may be swinging back the other way."
The second study was conducted by scientists at Brigham and Women's Hospital, Dana-Farber Cancer Institute and the Health System. Just like the first research, a significant decline in screening has been noted. For instance, in 2010, in men between ages 60 and 64 years, 45 percent tested for PSA in 2010 but only 35 tested in 2013, while from ages 50 to 54 years, 23 percent was recorded in 2010 but only 18 percent was noted in 2013.
"Less screening or discontinuing screening may lead to missed opportunities for detecting biologically important lesions at an early stage and preventing deaths from prostate cancer," said the study authors. "Some do go on to treatment eventually, but the majority do not die of prostate cancer," Dr. Eastham of Memorial Sloan Kettering Cancer Center said.
