Making Sense of Screening, by Sense About Science

I've added 'The Prostate Cancer Charity' comments on this report under this weeks News section.

Overall this new report should be of interest to just about everyone and is very informative.

Making Sense of Screening, by Sense About Science

The Prostate Cancer section found on page 13 is a bit of a disappointment in my opinion,relating to the screening issue but mostly the general feeling put over.

I don't know whether Peter Furness comments have been taken out of context but they appear aimed at scaring a man from taking an initial PSA test which is wrong,in my view:

"Peter Furness:

About two-thirds of men with raised PSA levels turn out not to have prostate cancer; but they have to go through a battery of further tests including rectal examinations, transrectal ultrasounds and prostate biopsies, which involves inserting a large needle into the prostate via the rectum, typically 12 times. The biopsy is painful and carries a small risk of serious infection."

I'm all for making the patient aware of the limitations of the PSA test but within a general screening report the above comments are unwelcome,in my opinion.

A PSA test should be carried out along with a "rectal examinations" (DRE) especially on any initial testing,in my opinion.

From what I could see there was no reference to 'watchful waiting' or 'Active Surveillance' which are other options but of course they don't come under the heading of 'screening' which is also the case for transrectal ultrasounds and prostate biopsies.

I disagree strongly with this separate comment if related to Prostate Cancer:

"Diseases, such as fast growing cancers, which progress rapidly are unlikely to be suitable for screening. The individual is likely to become symptomatic between screening tests and seek medical attention."

The comment above is based on a scenario of a screening program already set-up (the way I read it) so what happens if there is no screening program (as is the case today,in the UK)?

One case that I know about springs directly to mind is a man (late 60's) who had back pain who went to the doctor and after a couple of months of various tests they carried out a PSA test,the results were sky high and he was given a year to live,lasted about two and a half years with medication.

My view is that every man should be entitled to a free PSA test/DRE at any age and once a year,if the PSA test comes back high (not sky high) then do two more before any further invasive tests are carried out.Also from my research the GP must tell the patient what he mustn't do before a PSA test for example sex/ejaculating 48 hours prior.

In reference to should there be a screening program set up in the UK then yes would be my answer but if not financially viable along with the limitations of the PSA test which can't be questioned (but all we have at the present time)then greater public awareness campaigns would achieve the same objective without the 'screening program' label.

Sorry,it became a rant!