The World Association of Urology (AEU) does not recommend widespread screening all men over 50 years in prostate cancer from age 50 until they can discriminate tumor which threatens the life of patient since it has been shown that mass screening, but manages to reduce mortality, also entails overdiagnosis and unnecessary overtreatment in many cases be a very slow developing disease.
The voice of Scientific Activities of the AEU moved the recommendation, Carlos Llorente, in line with the European Association of Urology, during the press conference of presentation of the 34th National Congress of the AEU, in which more than a thousand specialists discuss the latest developments until next June 15 at Feria Valencia.
Llorente said that two studies, one American and one European, show conflicting results about the benefits of making a mass screening all men from age 50. Thus, the American research, called the PLCO, did not show that early diagnosis in prostate tumors ensure greater survival, unlike the case with screening for breast cancer.
In contrast, the European study showed that after eight years of follow up patients who had undergone screening tests had a mortality rate 21 percent lower. But this research also has found that this mass screening involves two side effects: the overdiagnosis and overtreatment in patients who require it.
In fact, said the screening detected one case of cancer per 1,400 patients, while saving the life of a person with a cancer detected by screening should be treated by treating 48 patients. So he said "there is no solid evidence" that may trigger to perform a comprehensive screening of the entire healthy population.
In this regard, Dr. Bernardino Minana, coordinator of Urologic Oncology Group of the Association of Urology, explained that the two tests that put the urologist on the trail of a possible prostate tumor are palpation of the prostate through the rectal determination of the PSA blood test is a simple blood test and is known as PSA. According to Dr. Minana, "there is no question the validity of early diagnosis with PSA because it is undeniable that has completely changed the prognosis of prostate cancer. 20 years ago most of these tumors could not be cured and it is now possible to address most successful of them. "
However, he questioned whether it is worth subjecting all men over 50 years for these tests "since they are not just those affected, who by the nature of the tumor, very slow progression, end up dying with the tumor and not because of him. In these cases, it considered that the option would be "monitoring without the use of medication" but that the fear that produces the disease causes many urologists and patients' preferred approach, "which" involves a consumption of resources and a series of co-morbidities to treatment that could be avoided. No obstante, however, showed that the problem is that if we give up the early detection "we are running away patients who have an aggressive tumor and it is the great benefit from early treatment.
Dr. Minana clarified that currently offered screening tests to patients who arrive in consultation with ages between 50 and 75. "It calls on the general population who go to a review, but it offers the possibility of analyzing the health of your prostate to those who come to the specialists for any other reason," says.
According to this expert, high-calorie diets, obesity, smoking and physical inactivity are directly associated with this type of tumor, the most common in men over 50 years, and the third most affects men of all ages , behind lung and stomach. Spain is estimated that each year nearly 6,000 people die from prostate cancer.
TREATMENTS
On the other hand, was also presented data from the REDUCE study showing that a new molecule is able to reduce by 23% of prostate cancer."It opens a new scenario to the possibility of reducing the risk of insignificant tumors and need not even be diagnosed," concludes Dr. Minana.
He explained that when the disease is located, doctors have two treatment options: radiation therapy and surgery (radical prostatectomy)
For its part, hormone therapy works by blocking the production of male hormones are stimulating tumor growth. In these cases, the indication is limited to cases where the tumor is already spread (metastasized)
University of Maryland
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