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New study won’t end debate on PSA test for prostate cancer
Robert H. Shmerling, MD,
Senior Faculty Editor, Harvard Health Publishing
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Never any good news, always doom and gloom. When will ya’ll be satisfied, when lettuce is 10 bucks a head and milk 20 bucks a gallon. Its always about a tiny fish or a breath of fresh air, NEVER the human race. Can’t clear, can’t fertilize, can’t spray, can’t water, can’t use fuel, how do you want a farmer to produce anything, or do you. GET REAL
great article…i have to admit
I have a small business that employs some migrant workers and it seems this topic does not get discussed much in the hispanic community, It would be helpful to reach out to this community
From a scientific point of view, this article and other coverage of this issue should not put any stress whatsoever on the European study’s finding that there are no statistically significant effects on all-cause mortality. This study’s sample size was simply much too small to detect a decrease in all-cause mortality of the size of the reduction in prostate cancer mortality in this study. Actually, the point estimate is that all-cause mortality actually decreased in the screening group, relative to the control group, by MORE than the reduction in prostate cancer mortality. But this decrease is statistically insignificant because the baseline for all-cause mortality is about 20%, and detecting a reduction from 20% to 19.9% is impossible with this study’s sample size. If you do a simple power analysis, the sample sizes of the European study only have a power of 8% to detect a reduction in all-cause mortality equal to the study’s estimated reduction in prostate cancer mortality. To have a study with a power of 0.80 to detect a decrease in all-cause mortality of this size would take a study with 2.3 million in the screening group and 2.3 million in the control group. Therefore, the lack of statistical significance to the estimated effects on all-cause mortality is a red herring, a distraction from the fundamental issues. No such statistically significant effects on all-cause mortality could ever have been reasonably expected from the design of the European study.
I understand that there is a concern over the validity of PSA testing, and I understand that 21% may in fact represent a small percentage.
But when you are suffering the possible effects of prostate cancer, urgency to urinate, inability to hold on to your urine, the consent embarrassment and pain associated with this condition, then a inexpensive test is of invaluable tool that helps relieve the stress and uncertainly of this irritating issue.
And ‘Yes’ I do suffer from BHP.
Stewart Justman wrote an e-single on this topic–the emphasis on screenings/early detection of prostate cancer, and how it can lead to over diagnosis and end up hurting patients. Very interesting read: http://goo.gl/oMiVz
There is nothing to penvert you getting any kinf of cancer. You can try to lower the risks but at the end of the day they say if its in your genes and you have that particular virus, you are going to get it regardless of what you do.
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