"You can observe a lot by just watchi... - Prostate Cancer N...

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"You can observe a lot by just watching."

dentaltwin profile image
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jamanetwork.com/journals/ja...

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dentaltwin
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dixiedad profile image
dixiedad

I can't argue with that.

dentaltwin profile image
dentaltwin in reply to dixiedad

Well, ya know, the U.S. Preventive Services Task Force kinda did (though they walked that partway back). And while there certainly are potential "harms" to screening, it's awfully hard to argue with PC-specific death numbers.

in reply to dentaltwin

I heartily agree with the conclusions of this article. I know I'm a pest but I continue to argue that the problem isn't with 'PSA over-screening' as the USPSTF concluded, but with 'over-treating'. What's the answer to that? I'm not sure, but it isn't to cut way back on PSA testing. There are no "harms" to PSA screening. It's only data, only information. How can that be harmful? It's what you do with that information, i.e. over-treatment that can be harmful. No screening = no information. How can that be goodness? My beef is with the USPSTF, not you or anyone on this forum.

dentaltwin profile image
dentaltwin in reply to

Understood, and agreed. I believe psychic stress is considered a "harm", but what's the alternative--sticking your head in the ground? The argument seems to be that PSA is sensitive but not specific. So great--when there's a better screening tool, we can use that one!

dentaltwin profile image
dentaltwin

Oh, I've had problems with the USPSTF from the moment they gave a blanket "D" recommendation for screening. As I recall, there were no urologic surgeons and no radiation oncologists in the task force, and I believe the chief was a pediatrician. I know this is really ad hominem, but there has to be a balance between bias and competence. Their listing of harms runs the gamut--from "overdiagnosis" to "overtreatment"; to the sequellae of biopsy and of treatment.

Yeah, the problem is overtreatment, and the increasing acceptance of AS seems to be addressing that.

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