Sunday, August 10, 2008

Prostate screening dubious

Doctors should stop routine prostate cancer screening of men over 75 because there is more evidence of harm than benefit, a federal task force advised Monday in a new blow to a much scrutinized medical test. The U.S. Preventive Services Task Force, which made the recommendation, reported finding evidence that the benefits of treatment based on routine screening of this age group "are small to none." However, treatment often causes "moderate-to-substantial harms," including erectile dysfunction and bladder control and bowel problems, the task force said.

The new guidance is the first update by the task force on prostate cancer screening since 2002. The last report on the subject from this panel of experts, which sets the nation's primary care standards, concluded there was insufficient evidence to recommend prostate screening for men of all ages.

In recent years, there has been a growing debate about the value of the somewhat imprecise PSA test to detect cancer, as well as the value of treating most prostate cancers. A number of experts contend patients are being overtreated. Most major U.S. medical groups recommend doctors discuss the potential benefits and known harms of prostate screening with their patients and make individual decisions. And most agree such testing shouldn't occur before age 50.

The federal task force reviewed past research in reaching its conclusion and "could not find adequate proof that early detection leads to fewer men dying of the disease," task force chairman Dr. Ned Calonge of Denver, said in a statement.

Prostate cancer is the most common cancer in American men -- about 220,000 cases will be diagnosed this year. It is the second leading cause of cancer deaths in men. But most tumors grow so slowly they never threaten lives. There is no accurate way to tell which tumors will.

Earlier this year, a study found that older men who already had early-stage prostate cancer were not taking a big risk by not treating it right away. The vast majority were alive 10 years later without significantly worrying symptoms or had died of other causes.

Prostate cancer treatments are tough, especially on older men. Some doctors instead recommend "watchful waiting" to monitor signs of the disease and treat only if they worsen, but smaller studies give conflicting views of the safety of that approach. The new guidelines from the Preventive Services Task Force were published in this month's Annals of Internal Medicine.


Study Confirms Abortion Increases Risk of Depression

I would be surprised if it were otherwise. It goes against every motherly instinct

A 2008 study by the University of Oslo in Norway has found that young adult women who have had abortions are more likely to become depressed. The study, which involved 768 women between the ages of 15 and 27, was carried out in order to "investigate whether induced abortion was a risk factor for subsequent depression."

According to Willy Pedersen from the University's Department of Sociology and Human Geography, who conducted the study, past studies have suffered in accuracy due to bad design, specifically a lack of control of "compounding factors."

The new study strove to prevent this problem by creating a comprehensive list of factors to question women on, including, "depression, induced abortion and childbirth, as well as sociodemographic variables, family relationships and a number of individual characteristics, such as schooling and occupational history and conduct problems."

Women in the sample who had abortions while in their twenties were "more likely to score above the cut-off point for depression," and although the likelihood was reduced when the compounding factors were accounted for, their propensity to become depressed "remained significant." The study concluded that, "Young adult women who undergo induced abortion may be at increased risk for subsequent depression."


1 comment:

Secret said...

OK, I gotta call you on this one - I normally agree with what you say, but I think that "motherly instinct" is a little bit emotive - is this a scientifically verifiable quality? Where are the double blind tests on "motherly instinct"? I don't mind you making a moral judgement about abortion - that's praiseworthy. But you have nothing to gain by linking these qualms to the kind of junk science you normally decry.