Here we go again. More debate about prostate cancer screening. I wonder of cost of services, not just screening but also treatment is driving this debate? Rather than focus on screening I wish the debate was focused on how to evaluate patients for treatment. We know that some men are still diagnosed with advanced cancer. We also know that some men may be over treated. It bothers me that we may be sacrificing some men because some are over treated.

To read the memo quoted below click here. 

Ruth Etzioni, Ph.D., of the Fred Hutchison Cancer Research Center in Seattle and colleagues reviewed several recent articles on PSA velocity. They point out in their commentary the important differences between studies of PSA velocity in the cancer screening setting and studies of PSA velocity and prostate cancer progression after diagnosis. These differences lead them to question whether PSA velocity is useful for early detection of prostate cancer.

No studies to date have addressed the costs and benefits of using PSA velocity for prostate cancer screening. “One of the main goals of this commentary has been to reconcile some of the inconsistencies across studies by highlighting features of study design and potential sources of bias that might explain why different types of studies have produced differing results,” the authors write.

I wish I had a solution. I would appreciate feedback from people who read this blog.

To read the abstract in the Journal of the National Cancer Institute click here.