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Prostate cancer screening: More harm than good?

Prostate cancer screening: More harm than good?

One meaning of screening is the investigation of a great number of something (for instance, people) looking for those with a particular problem or feature. For example at an airport many bags are screened by x-ray to try to detect any which may contain weapons or explosives, and people are screened by passing through a metal detector. If only part of a population is screened, screening is equivalent to sampling in statistics.

Screening can also mean preventing access of something by some sort of barrier. Particular cases:

Electromagnetic shielding in physics, the exclusion of electric, magnetic, or electromagnetic fields by a metallic screen or shield

In atomic physics and chemistry, the screening effect or atomic shielding is the reduction of effective nuclearcharge by intervening electron shells

Screening (printing), a process that represents lighter shades as tiny dots, rather than solid areas, of ink by passing ink through a perforated screen

The investigation of a large population is related; the members of a population are filtered by a metaphorical, rather than physical, screen

Screening is a process stage when cleaning paper pulp

Routine screening for prostate cancer has resulted in more than 1 million U.S. men being diagnosed with tumors who might otherwise have suffered no ill effects from them, U.S. researchers said on Monday.

They said prostate cancer screening is a double-edged sword, catching serious cancers in a few but causing needless worry and expense for the majority of men, who may be getting treatment for tumors growing too slowly to do any harm.

The team looked to see how many additional men have been diagnosed with prostate cancer since the introduction in 1986 of a widely used blood test for prostate cancer that looked for a prostate-cancer specific antigen, or PSA.

“Our estimate is that number is about 1.3 million people in the United States. That is a huge effect,” said Dr. H. Gilbert Welch of the VA Outcomes Group in White River Junction, Vermont, whose study appears in the Journal of the National Cancer Institute.

More than 1 million of those were treated, they found.

“These are men who could not be helped by treatment because their cancer was not destined to cause them symptoms or death,” Welch said in a telephone interview.

The increased diagnosis rate more than tripled in men aged 50 to 59 and increased more than a sevenfold in men under age 50.

And while prostate cancer deaths have declined since the introduction of PSA testing, Welch said about 20 men had to be diagnosed and treated for every one who benefited.

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Cancer

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A young woman exhales cigarette smoke in Shanghai, China. The People’s Republic of China is both the world’s largest producer and largest consumer of tobacco, which has led to an impending cancer epidemic in the most populous country on Earth.

Cancer is a disease that begins as a renegade human cell over which the body has lost control. In order for the body and its organs to function properly, cell growth needs to be strictly regulated. Cancer cells, however, continue to divide and multiply at their own speed, forming abnormal lumps, or tumors. An estimated 6.7 million people currently die from cancer every year.

Not all cancers are natural-born killers. Some tumors are referred to as benign because they don’t spread elsewhere in the body. But cells of malignant tumors do invade other tissues and will continue to spread if left untreated, often leading to secondary cancers.

Cancers can start in almost any body cell, due to damage or defects in genes involved in cell division. Mutations build up over time, which is why people tend to develop cancer later in life. What actually triggers these cell changes remains unclear, but diet, lifestyle, viral infections, exposure to radiation or harmful chemicals, and inherited genes are among factors thought to affect a person’s risk of cancer.

Lung cancer is the world’s most killing cancer. It claims about 1.2 million victims a year. Most of those victims are smokers, who inhale cancer-causing substances called carcinogens with every puff. Experts say around 90 percent of lung cancer cases are due to tobacco smoking.

Breast cancer now accounts for almost one in four cancers diagnosed in women. Studies suggest the genes you inherit can affect the chances of developing the illness. A woman with an affected mother or sister is about twice as likely to develop breast cancer as a woman with no family history of the disease. Lifestyle may also have an influence, particularly in Western countries where many women are having children later. Women who first give birth after the age of 30 are thought to have a three times greater risk of breast cancer than those who became mothers in their teens.

Geographical Distinctions

There are also stark geographic differences, with incidence rates varying by as much as thirtyfold between regions. In much of Asia and South and Central America, for example, cervix cancer is the most deadly in females. However, in North America and Europe another kind of gynecological cancer, ovarian cancer, is a more serious threat.

Among males, southern and eastern Africa record the second and third highest rates of oesophageal, or gullet, cancer after China, but western and central regions of Africa have the lowest incidence in the world. Differences in diet may explain this.

Nevertheless, the reasons why many cancers develop remain elusive. Brain cancer, leukemia (blood cancer), and lymphoma (cancer of the lymph glands) are among types that still mystify scientists.

Treatments

Yet ever more people are surviving diagnosis thanks to earlier detection, better screening, and improved treatments. The three main treatment options are surgery, radiotherapy and chemotherapy. Radiotherapy, also called radiation therapy, involves blasting tumors with high-energy x-rays to shrink them and destroy cancerous cells. Chemotherapy employs cancer-killing drugs.

Even so, future cancer cases are predicted to climb, since the world’s population is aging. The proportion of people over age 60 is expected to more than double by 2050, rising from 10 percent to 22 percent. This will add an estimated 4.7 million to the cancer death toll by 2030.