Archive for August, 2009

BETHESDA, MD – The introduction of prostate-antigen screening has resulted in over 1 million additional men over the last 23 years being diagnosed and treated for prostate cancer—most of whom were likely overdiagnosed, researchers reported in a new study recently published online in the Journal of the National Cancer Institute.

Overdiagnosis has been associated with early diagnosis in prostate cancer, but there have been no previous national estimates of its magnitude.

Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program, H. Gilbert Welch, M.D., MPH, of the White River Junction VA and The Dartmouth Institute for Health Policy & Clinical Practice., and Peter C. Albertsen, M.D., of the University of Connecticut, examined age-specific prostate cancer incidence rates to determine the excess (or deficit) in the number of American men diagnosed and treated in each year after 1986. Prostate-antigen screening screening was introduced in 1987.

According to the study, an additional 1.3 million men were diagnosed—that would otherwise have never been diagnosed absent screening—and more than 1 million have been treated since 1986.

“Given the considerable time that has passed since prostate-antigen screening screening began, most of this excess incidence must represent overdiagnosis,” the authors write. “All overdiagnosed patients are needlessly exposed to the hassle factors of obtaining treatment, the financial implications of the diagnosis, and the anxieties associated with becoming a cancer patient…”

The increased diagnosis has been most dramatic among younger men: more than tripling since 1986 in men aged 50-59 (from 58.4 to 212.7 per 100, 000) and more than a sevenfold increase in men under age 50 (from 1.3 to 9.4 per 100,000).

In an accompanying editorial, Otis W. Brawley, M.D., chief medical officer of the American Cancer Society, discusses how screening practices for prostate cancer have surged over the last 20 years, despite little evidence that it has saved lives.

According to Brawley, the highly pushed early-detection message has skewed public opinion and de-legitimized the questions concerning screening, causing many men to be overdiagnosed. Mortality has decreased since the early 1990s, the editorialist points outs, but reasons for this decline are unclear.

“We desperately need the ability to predict which patient has a localized cancer that is going to metastasize and cause suffering and death and which patient has a cancer that is destined to stay in the patient’s prostate for the remainder of his life,” he writes.

- MFP Wire Services
- 8-31-2009

By Ed Susman

BARCELONA, Spain – The key to stopping heart disease is to prevent it – and more than 20,000 cardiologists will focus on that aspect of treatment at the 2009 European Society of Cardiology meeting here.

“Prevention cannot be done by the doctor alone,” said Roberto Ferrari, MD, president of the ESC and professor of cardiology at the University of Ferrara, Italy. He appealed to doctors, patients and media to promote awareness of heart disease and beneficial changes in lifestyle.

“Avoid elevators, eat better food and stop smoking,” Dr. Ferrari said at the opening press briefing at the five-day meeting that may draw a total of more than 30,000 people – including industry representatives and allied health care professionals.

Roberto Ferrari, MD

He said that the attendance at the meeting, which could set a record for the ESC meeting was influenced by the fact that “Barcelona is a lovely city” and the quality of the scientific presentations.

New scientific data will highlight the meeting, said program chairman Fausto Pinto, MD, professor of cardiology at the University of Lisbon, Portugal. The program committee reviewed 9848 scientific abstracts for the meeting, selecting 4085 for presentation, mostly as posters. More than 700 studies were selected for oral presentations.

Although the meeting is based in Europe, presentations have a distinctly international flavor, Dr. Pinto said. More abstracts were accepted from Germany – 531 – than any other country, but Japanese researchers had 241 papers accepted, good enough for 6^th place, and 162 papers were accepted from United States scientists, ninth place.

Fausto Pinto, MD

Important new research will be presented in Hot Line sessions and in Clinical Trial Updates, Dr. Pinto said.

–08-29-2009