Probability, Uncertainty, and Prostate Cancer
Authors: John Concato
Journal: Annals of Internal Medicine (2013)

Editorials5 February 2013Probability, Uncertainty, and Prostate CancerJohn Concato, MD, MPHJohn Concato, MD, MPHFrom Veterans Affairs Connecticut Healthcare System and Yale University, West Haven and New Haven, Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-3-201302050-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The topic of screening for prostate cancer highlights the interface between clinical care and patient-oriented research. From a clinical perspective, the importance of prostate cancer is evident in projections of 242 000 incident diagnoses of and 28 000 deaths from the disease during 2012 (1). From a research perspective, limited data are available to determine whether treatment of screen-detected prostate cancer improves survival. The optimal approach to screening remains elusive, with conflicting and controversial recommendations.Although underappreciated by the public and some clinicians, early detection of prostate cancer does not automatically lengthen survival. Issues include the fact that a man's diagnosis-to-death interval ...References1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10-29. [PMID: 22237781] CrossrefMedlineGoogle Scholar2. Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991;324:1156-61. [PMID: 1707140] CrossrefMedlineGoogle Scholar3. Barry MJ. The PSA conundrum [Editorial]. Arch Intern Med. 2006;166:7-8. [PMID: 16401804] CrossrefMedlineGoogle Scholar4. Concato J. What will the emperor say? Screening for prostate cancer as of 2008. Cancer J. 2009;15:7-12. [PMID: 19197166] CrossrefMedlineGoogle Scholar5. 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[PMID: 11830606] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John Concato, MD, MPHAffiliations: From Veterans Affairs Connecticut Healthcare System and Yale University, West Haven and New Haven, Connecticut.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-2994.Corresponding Author: John Concato, MD, MPH, Clinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, Mailcode 151B, Building 35A, West Haven, CT 06516; e-mail, [email protected]. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparative Effectiveness of Alternative Prostate-Specific Antigen–Based Prostate Cancer Screening Strategies Roman Gulati , John L. Gore , and Ruth Etzioni Metrics Cited byThe Rising Incidence of Thyroid Cancer: Contributions from Healthcare Practice and Biologic Risk FactorsHuman antigen R is positively associated with malignant aggressiveness via upregulation of cell proliferation, migration, and vascular endothelial growth factors and cyclooxygenase-2 in prostate cancerExpression of the SIBLINGs and their MMP partners in human benign and malignant prostate neoplasmsExpression of spermidine/spermine N 1 -acetyl transferase (SSAT) in human prostate tissues is related to prostate cancer progression and metastasisInternational Perspectives on Screening 5 February 2013Volume 158, Issue 3Page: 211-212KeywordsBiopsyCancer screeningCancer treatmentDecision makingMortalityProstate cancerProstate diseasesRacial and ethnic issuesRandomized trialsVeteran care ePublished: 5 February 2013 Issue Published: 5 February 2013 PDF downloadLoading ...