European study: PSA screening reduces mortality up to 31%
    Dec 17, 2009
    Urology Times E-News

    PSA screening has reduced prostate cancer mortality up to 31%, according to findings from the European Randomized Study of
    Screening for Prostate Cancer (ERSPC).

    Preliminary findings from the ERSPC had already shown screening reduced prostate cancer deaths by 20% (N Engl J Med 2009; 360:
    1320-8). This latest analysis corrects for non-attendance and contamination to assess the effectiveness of PSA testing in those men
    actually screened.

    From 1992, the ERSPC study randomized 162,000 men, aged 55 to 69 years, in seven European countries to either a screening or a
    control group. Those who were screened were given a blood test to detect PSA levels: if PSA was 3.0 ng/mL or more, they were offered a
    biopsy. Screening took place on average every 4 years. Mean follow-up was 9 years.

    Using retrospective data from the Dutch arm of the study, the ERSPC has shown that using a screening algorithm alongside PSA testing
    can reduce the number of unnecessary biopsies. The findings, to be published in European Urology (January 2010), suggest that a PSA
    cutoff level of 3.0 ng/mL, combined with an individual risk assessment, would reduce biopsies by 33%.

    The majority of cancers potentially missed would be indolent, so there would be no benefit from active treatment. Increasing the PSA
    cutoff level from 3.0 ng/mL to 4.0 ng/mL may save a similar number of biopsies, but will miss more clinically significant cancers,
    according to the researchers, led by Monique J. Roobol, PhD of Erasmus Medical Center, Rotterdam, the Netherlands.


    Of note, the pace of change in information has been faster than ever during tech age; so has been for PSA.  As possibly predicted,
    more change on the subjects of PSA and prostate cancer will take place and more confusion and anxiety on prostate cancer and PSA
    will follow. But don't bother; let us focus on what we can do now to make a significant difference in life and survival. Please remember
    the following facts of life:

    1. Life is a one-way street of accumulation, modification, and continuation from inception to eternity.

    2. Do not let the undesirable power of hypocrisy and commercialism erode, distort, and destroy the truth and the value of life leading to
       perceive what you like, want, and love do not reflect what you need.

    3. Especially in dealing with medical care, please understand and realize the existence of evil power of magic words-free, instant,
       perfect, excellent, guaranty, best, cure-from hypocrisy and commercialism. In real world, the scenario suiting the scenes of these
       words has rarely and even probably never happened. At most, something reasonable may be available, resulting from working
       together and applying currently available knowledge, technology, skill, medication, and common sense at a reasonable time in a
       reasonable way to a reasonable person.


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