An answer finally…sort of…

Between 10 and 12 years ago, the USPSTF had just recommended AGAINST routine prostate cancer screening, and I had just read about a large NIH study that would definitively answer the question of whether or not to screen, the PLCO study.  

For years, as I taught students, residents, and patients about the risks and unknown benefits of prostate cancer screening, I would say, "There's a large trial underway to answer the question about prostate cancer screening, so we should know in 2008."

Well, the PLCO study results are finally in…well, at least 7 years' worth.  And a large multi-center study from Europe was just completed.  And the results?  Well, they're complicated.  We knew they would be, didn't we?  But overall, they should at least legitimize the position of those of us who have refused to merely jump on the screening bandwagon without questioning.

PLCO showed no reduction in death in those screened…and in fact showed a slight NON-significantly increased risk of death among those screened.

The European trial showed a slight benefit, but 1410 would need to be screened, and, importantly, 48 people would need to be TREATED in order to prevent one death.

These results, I assume, will be debated for a while, and the data collection and analysis will continue in the studies.  But it's nice to finally have some data to point to in my male physical exam appointments.