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Science is not shy about ambiguity, never more so than when it comes to medical advice. So here's the latest recommendation on prostate-cancer screening: Men should continue to have both a manual prostate exam and a blood test for prostate-specific antigen (PSA) every year - bearing in mind that neither test may affect your odds of surviving prostate cancer. (Read "Can a Urine Test Detect Deadly Prostate Cancer...
...Those seemingly contradictory conclusions are part of the results of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial (PLCO), a sweeping, 17-year project conducted by the National Cancer Institute (NCI). The prostate findings were published online on March 18 in the New England Journal of Medicine, and while they may leave many men scratching their head, they do offer some valuable information about the benefit of screening. (Read "Vitamins Do Not Prevent Prostate Cancer, Study Finds...
...health-care centers across the U.S. Half the men were randomly assigned to receive regular PSA tests and physical exams. Since investigators could not ethically recommend that the other group not receive the screenings - which are, for now, considered the first defense against prostate cancer - they were simply given no particular recommendation at all. Half that group went ahead and had the exams on their own, and the remaining...
...results confirmed the value of annual screening in detecting cancer. After seven years, 2,820 cases of cancer were caught in the group that had been instructed to have annual checkups, vs. 2,322 in the group that was left on its own - a difference of 22%. The reasonable conclusion is not that the second group just happened to be healthier but that a significant share of their cancers went undetected. So case closed, right...
...necessarily - at least not when you consider mortality. At the end of the seven years, 50 men in the screening group had died of prostate cancer, compared with 44 in the other group; at the end of 10 years, those numbers were 92 to 82. There were actually more deaths in the screening group, but the differences were too small to be statistically significant; in other words, it was a wash...