I am puzzled lately with all the news that prostate cancer screening might be controversy. The studies that were released this week in an excellent journal called the New England Journal of Medicine, one completed in the USA and the other in Europe, looked into the popular idea that routine screenings reduces cancer-caused deaths.
In the trial, half of the estimated 70,000 men in the States were assigned to 10 years of annual screenings. The remaining participants were assigned to get their usual health care without any recommendations for or against annual prostate examinations. There is no significant result yet, other than 2 people were saved for 48 patients overtreated.
The European study followed 182,000 patients for 15 years in seven different countries. The study showed that there was a 20% reduction in the rate of death from prostate cancer – which is good, but lower than what the scientific community was expecting.
Both the studies, however, employed different methodologies and frequency of screenings. So it’s very hard to compare both of them.
There probably will be a lot of ink on the subject this year. However, it would have been nice if the studies had taken in account whether the lifestyles of the participants had changed after the first prognosis. How good is screening if your lifestyle stays the same and you don’t follow the Cancer Association recommendation?
Cancer Association recommendations:
1. Be Active (Exercise minimum 30 minutes 3 times a week)
2. Eat well
3. Eat 10 fruits and vegetables a day
4. Eat less red meat or delicatessen (max a pound a week for red meat and 1/3 pound for delicatessen)
5. Keep a healthy weight (between 20 and 25) calculator
6. Eat whole grain
7. If you drink alcohol do it with moderation and choose red wine
8. Don’t smoke
References
1. Screening and Prostate-Cancer Mortality in a Randomized European Study. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, Kwiatkowski M, Lujan M, Lilja H, Zappa M, Denis LJ, Recker F, Berenguer A, Määttänen L, Bangma CH, Aus G, Villers A, Rebillard X, van der Kwast T, Blijenberg BG, Moss SM, de Koning HJ, Auvinen A; the ERSPC Investigators. N Engl J Med. 2009 Mar 18.
2. Mortality Results from a Randomized Prostate-Cancer Screening Trial. Andriole GL, Grubb RL 3rd, Buys SS, Chia D, Church TR, Fouad MN, Gelmann EP, Kvale PA, Reding DJ, Weissfeld JL, Yokochi LA, Crawford ED, O’Brien B, Clapp JD, Rathmell JM, Riley TL, Hayes RB, Kramer BS, Izmirlian G, Miller AB, Pinsky PF, Prorok PC, Gohagan JK, Berg CD; the PLCO Project Team. N Engl J Med. 2009 Mar 18.
3. http://www.cancer.ca/canada-wide/prevention.aspx?sc_lang=en