The Burrill Report


There’s nothing quite like the cries of resistance a latex glove makes as it is pulled downward on a physician’s hand that ends with the startling snap as the doctor instructs the compliant patient to hop off the table, turn around, and bend over.

There’s a reason those hospital gowns leave your ass hanging out the way they do. But the next time you head off to the doctor for an annual check up, you may want to be armed with a pair of studies from the British Medical Journal.

A newly published 20-year follow-up study from researchers in Scandinavia based on a randomized, controlled trial of nearly 1,500 men in Sweden suggests routine screening does more harm than good. The study’s early years did not make use of the prostate-specific antigen test because it was not yet available, but it was eventually incorporated into the study.

While screening and treating men with detected tumors might reduce deaths specifically from prostate cancer by up to a third, the researchers note there would be a considerable risk of overdetection and overtreatment. A previous trial found that to prevent one death from prostate cancer, 1,410 men would need to be screened and 48 treated.

“After 20 years of follow-up, the rate of death from prostate cancer did not differ significantly between men in the screening group and those in the control group,” they said.

The study follows a separate one published back in September from researchers at the University of Florida and the University of South Florida also published by the journal. That study of previous research examining the benefits and harms of prostate cancer screening found that routine screening did not significantly reduce prostate cancer deaths.

The findings were based on randomized controlled trials comparing screening by prostate-specific antigen with or without digital rectal examination versus no screening. (For the record, digital rectal examination does not involve high-tech gadgetry. “Digital,” in this instance, refers to the digit on the gloved one’s hand).

Though routine screening and early detection are usually good things, they turn out not to be so in the case of prostate cancer, according to the findings. That may be surprising given that prostate is the most common non-skin cancer among men worldwide and second only to lung cancer as the deadliest cancer.

But the researchers found in the six randomized, controlled studies involving nearly 400,000 patients that screening was associated with a 46 percent increase in diagnoses of prostrate cancer in the screening arm compared with no screening, an increase attributable mainly to detection of early-stage prostate cancer.

The researcher said their analysis failed to show “a clinically important” benefit of screening on death from prostate cancer. “Our results confirm previously voice concerns about overdiagnosis of prostate cancer–that is, detection of cancer that will not negatively affect survival,” they concluded.

Of course, hospital gowns don’t come with pockets for easy storage of reprints of research studies to keep at the ready for when the doctor walks in the room. No doubt, a little creativity on where to store them may go a long way to avoiding unnecessary procedures.


April 01, 2011
http://www.burrillreport.com/article-wrecked_%e2%80%98em_damn_near_killed_him.html