Prostate Health Screening Problems – There is a problem with the current state of prostate health screening.
Currently, there are two methods for prostate screening. The first method is the digital rectal examination (DRE). In this method, the examiner inserts a gloved, lubricated finger into the rectum to examine the adjoining prostate.
The second is the prostate-specific antigen (PSA) blood test, which measures the concentration of this molecule in the blood. This method dates back to 1970 and the discovery of PSA (prostate-specific antigen) by Richard J. Ablin, Ph.D.
The not so healthy prostate-screening test
The problem Some people believe that the tests in which the PSA was used, instead of providing proper results have led to millions of needless operations, complications, and sometimes even deaths. All this due to over diagnosis and many cases of absolutely unnecessary treatment.
Not long ago, a Swedish Goteborg study has shown that the PSA screening can help preserve prostate health and reduce deaths due to prostate cancer staggering 44%. This has provided a basis for another study, the European Randomized Study of Screening for Prostate Cancer, which found out 20% reduction of prostate cancer deaths thanks to PSA screening.
Unfortunately, there’s an issue regarding both of the mentioned studies.
One of the issues is related to methodology and the results. Two Australian researchers have raised concerns: Ian E. Haines and George L. Gabor Miklos in the Journal of the National Cancer institute.
They had a closer look at the men surveyed in both of the tests; the men were split into two distinctive groups – those who underwent periodical PSA tests and other who were not screened at all. The results of the European Randomized Study were reported based on a study group from seven countries and have been printed in The New England Journal of Medicine; the Goteborg one was a single-site study based only on Swedish men and has been later published in the Lancet Oncology.
The hidden information
Apart from the clear differences in the choice of men for the studies, Haines and Miklos have found something quite unusual regarding the data sets – most of the European Randomized study data came from an independent Finnish study in which no meaningful results about the lifesaving benefits have been found in PSA screening.
Further inaccuracies have been found in the methods of patient treatment. As it turned out, some of the men who ended up developing prostate cancer have been given disproportionate amounts of hormonal monotherapy – which is now by some researchers thought to be responsible for increasing the speed of cancer development.
Information about which groups these men were in – whether they received PSA screening or not – has been hidden and has not been published in the official reports, despite its significance for the final results. Moreover, the researchers were reluctant to release the European data even after both Drs. Haines and Miklos requested it, in order to undertake independent analyzes.
Pharmaceutical corporations may sit in doctor’s pockets
However, the biggest issue of these studies has been discovered to lie in the potential conflicts of interest between some of the senior researchers connected to the European trials and their American supporters. They are related to patents that some of them may be holding, and which are related to either prostate cancer diagnosis or PSA, as well as to the marketing process of the PSA screening tests and companies involved. The disclosure of the relationships has been reported by the International Committee of Medical Journal Editors and has been published in CA: A Cancer Journal for Clinicians.
These (potentially) unethical research methods resulted in a flawed data, on the basis of which physicians, who did not examine it in depth, are now taking care of their patients and of their patient’s prostate health. And because authors are refusing to make the data public, the size of the flaw remains unknown.
In the light of the above problem and as part of America’s efforts to reform its health care system, it is crucial to form a statement of principles concerning the need for transparency of medical research data.
American regulatory bodies must emphasize the need for much higher transparency of research, studies and clinical trials – especially those that are taxpayer-funded. The practice of hoarding flawed data is unacceptable in any case – and, in particular, when people’s lives are at stake; meaning that all results should be opened to thorough inspection by independent investigators, who have no business interest in them and have no links to the industry.
The United States Preventive Services Task Force (USPSTF) now recommended against PSA screening in healthy men finding that the potential risks outweigh the potential benefits.
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