A new study has revealed a decrease of screening and diagnosis of prostate cancer in the United States in recent years, and reducing the use of definitive treatment for men who have been diagnosed. The results were published in the early online mode in CANCER, a peer-reviewed journal of the American Cancer Society.
There is considerable debate regarding the evaluation of prostate cancer screening by testing the prostate-specific antigen (PSA), and the recommendations of the Task Force on the United States Preventive Services (the USPSTF) against PSA testing in 2012, is located in the center of this debate. This recommendation has been partially caused by the potential harm, such as erectile dysfunction and urinary incontinence associated with treatment of clinically insignificant prostate cancer with radical prostatectomy or radiation.
To explore the use of the diagnosis and treatment of prostate cancer in the years associated with the recommendation of the USPSTF, James Kearns, MD from the School of Medicine of University of Washington in Seattle, and his colleagues analyzed the application MarketScan, which contain more than 30 million private insurers patients in the United States. The team specifically studied information related to PSA testing, prostate biopsy, the diagnosis of prostate cancer and the final local treatment in men aged 40-64 years 2008-2014. Men under the age of 65 years can get the most from radiation or surgery for prostate cancer because prostate cancer usually causes problems in men many years after diagnosis.
When analyzing about 6 million men with PSA testing, prostate biopsy and detection of prostate cancer declined significantly in the period from 2009 to 2014, especially after 2011. Indicator of prostate biopsies on 100 patients with a PSA study period decreased from 1.95 to 1.52. The incidence of prostate cancer after a biopsy has increased over the study period from 0.36 to 0.39. Of new prostate cancer diagnoses share controlled by the final local treatment decreased from 69 percent to 54 percent. Since 2011, PSA levels and the incidence decreased significantly.
"We found that few men with prostate cancer diagnosed were treated with surgery or radiation. This means that they are likely to choose active surveillance for low-risk prostate cancer, "- Dr. Kearns said. "This is important because active surveillance was safe for many women, and it avoids the problems associated with the treatment of prostate cancer, such as urinary incontinence and erectile dysfunction. Part of the controversy around the screening of prostate cancer was the fact that men who do not require surgery or radiation for their prostate cancer are still subjected to these treatments. "