I don't get my PCa news from Fox News, etc, so I missed the big fuss when the new study [1] was picked up by the media.
I caught up with it when Denise Grady wrote about it in the New York Times last Wednesday:
"HEALTH | THE DEBUNKER"
"Flawed Study of Advanced Prostate Cancer Spreads False Alarm"
"The reports suggested that recent medical advice against routine screening might be to blame for the apparent increase in advanced cases, by leading to delays in diagnosis until the cancer reached a late stage."
"But the frightening news appears to be a false alarm — the product of a study questioned by other researchers but promoted with an incendiary news release and initially reported by some news media with little or no analysis from outside experts."
So, no need for the men who stopped screening to worry?
On Nov 17, 2015, Denise Grady also reported [3] that:
"Fewer men are being screened for prostate cancer, and fewer early-stage cases are being detected, according to two studies published Tuesday in The Journal of the American Medical Association.
"The number of cases has dropped not because the disease is becoming less common but because there is less effort to find it, the researchers said.
"The declines in both screening and incidence “could have significant public health implications,” the authors of one of the studies wrote, but they added that it was too soon to tell whether the changes would affect death rates from the disease."
There is no mystery here. Screening levels have declined. Inconsequential PCa is not being detected and over-treated, just as the US Preventive Services Task Force (USPSTF) planned. However, the price is being paid by men who are diagnosed only when symptoms occur.
Here's what the study found:
"The annual incidence of metastatic prostate cancer increased from 2007 to 2013 ... and in 2013 was 72% more than that of 2004."
"(1685 cases in 2004 to 2890 in 2013)"
It's all very well to call this a classic blunder of confusing number of cases with rates, but it looks like the paper is being buried as bad science, when an increase in the rate of metastatic disease at diagnosis is an inevitable outcome of men listening to the USPSTF.
This is how last week's Times' article ends:
"Dr. Brawley said that even if further analysis found an increase in advanced cases, it would probably be from improvements in magnetic resonance imaging scanning. In other words, rather than reflecting more cases of advanced disease, the increase would mean doctors had become better at finding it."
OK, so we are doing less screening, but getting better at finding advanced disease?
-Patrick
[1] nature.com/pcan/journal/vao...