Screening Test For Prostate Cancer Essay

Today, prostate cancer is usually detected through screening, and there are two methods for early detection. The prostate-specific antigen test (PSA) is used, but there are

In the case for PSA screening, PCa is the leading internal malignancy in US men and the second leading cause of cancer death in American men. Early detection of prostate cancers offers the best chance of cure. The PSA blood test is the best chance of cure. Currently, the PSA blood test is the best currently available way to detect PCa and it is easy, safe and inexpensive. PSA test results is a piece of information, it is what doctors do with the information that becomes the issue. However, the great majority of PSA detected tumors have the histologic characteristics of clinically important cancers. Also, PSA detection has found tumors early advancing the diagnosis by Seeral years (5-13) and prostate cancer mortality rates in U.S have decreased by 4% (patho book) since 1992, which is 5 years after initiation of prostate screenings. The dilemma is over treating the clinically unimportant disease versus under

Prostate Cancer is a disease in which there is an uncontrolled growth of cells that lines the ducts of the prostate gland. The abnormal cells can spread throughout the prostate and nearby organs, such as the seminal vesicles. If not caught early they can spread (metastasized) to other organs of the body through the lymph or blood stream. (“...Treatment...” 13) Prostate Cancer can be like a silent killer. Some may show signs and symptoms of this disease while others may not. Some symptoms may include frequent urination, blood in the urine or semen, delayed or slowed start of urinary stream and dribbling or leakage of urine. Diagnosis testing for Prostate Cancer are digital

et al who found a very high positive correlation between the type of curve and pathological staging (r= 0.88 , p<0.001) (21) .

Biopsy of the tumor. This is when a sample of the tumor is removed with a needle and studied.

Each year approximately 233,000 men will be diagnosed with prostate cancer (Eggener, Cifu, & Nabhan, 2015). In 2015, prostate cancer was the second most common cancer related cause of death among United States men (Eggener, et. al., 2015). While the majority of prostate cancers are slow growing with a 5-year survival rate of approximately 98%, statistics show that when prostate cancer is identified as metastatic, the 5-year survival rate dramatically drops down to 20-25% (Eggener, et. al., 2015). According to these numbers alone, it appears screening for prostate cancer would be a well-accepted practice. However, current methods of screening for this cancer are controversial and has lead organizations like the U.S Preventative Service Task Force (USPSTF) and the American Cancer Society (ACS) to different guidelines for screening.

The first reason being the level accuracy of PSA testing is questionable. The test determines a positive for the cancer based on the levels of prostate-specific antigens in the blood of the patient, which can be abnormally high for multiple other reasons not related to prostate cancer. The major evidence supporting said claim is that individuals with more than 4.0 ng per mL (the threshold to test positive) can have false positive rates of 70% (Mulhem 2). The second reason would be the implications of testing positive for prostate cancer, including but not limited to unnecessary treatment of the disease. While the analysis does not back up unnecessary treatment with any statistical evidence, it does go to explain further tests and procedures to confirm and understand the nature of the patient’s condition. This bleeds over to the negative physical and psychological side-effects of regular prostate cancer screening cited by the analysis. Mulhem explains that after testing positive for prostate cancer, more tests are performed to determine the accuracy of the screening and if so, reveal the specificities of the cancer. The most common of these tests being the prostate biopsy, a procedure that causes a significant portion of participants to develop moderate to severe problems requiring a follow-up with their doctor (Mulhem

Prostate cancer is a kind of cancer that affects the prostate gland in men. It is a common cancer that grows slowly and its treatment can be done successfully if it is detected at an early stage. Sometimes, symptoms are not visible in case of cancer limited to the prostate gland which may result into metastatic cancer. To detect the symptoms, active surveillance can be done. There are various options available

(a) Grading of the tumor: is very important prognostic factor, well differentiated tumors are associated with better OAS than poorly differentiated tumors (Wasif et al.,

Since tumor instability is not only seen between the primary and relapse setting but also throughout tumor progression, this makes clinical decisions more difficult and makes taking biopsies in a consecutive manner in the advanced setting a very important step to optimize treatment decision making for patients (Lindstrom et al,

Pathologic staging is likely to be more accurate that clinical (American cancer society, 2015). Pathologic staging is

An indicator of the future course of prostate cancer is predicted by tumor grade and stage. The age of the patient does not seem to play a role in the rate at which tumors spread and become life threatening. At the present moment, determining the stage of prostate cancer without surgery is unreliable. As soon as the cancer spreads to bones or other organs, hormonal treatments can only achieve temporary remissions often measured in months.

The recommendation to reduce PSA screening by the Canadian Task Force of Preventative Health Care originated from the observations that PSA screening does not decrease the relative risk for acquiring PCa, nor does it decrease the mortality rate of PCa. Since the implementation of proactive and opportunistic PSA screening in Canada the annual incidence of PCa has increased but the mortality rate has not decreased (Pron, 2015). Ontario spends approximately $119.2 million on PSA screening annually and considering PCa mortality rates decreased prior to PSA screening introduction in the late 1990s, the $119.2 million spent on PSA screening appears redundant (Ontario Health Technology Assessment, 2015).

Although PSA Screening tests can facilitate to detect prostate cancer in its early stage, there is controversy and concern about patient being unnecessarily treated and over-diagnosed. The reliability of prostate specific antigen (PSA) testing is very poor. PSA values could be false positive caused by conditions such as benign prostatic hyperplasia, ejaculation, perineal trauma and PSA value cannot be used to rule out prostate cancer. PSA-screening misses a considerable number of patients with PCa (false-negatives) and wrongly suspects or false-positives (Hayat, Nordin and Berglund, 2013). Sensitivity of the test is determined with the percentage of people tested with the disease that had positive results equals the number of patients that were true positive. The cut-off range for an abnormal PSA screening is 4.0 ng/mL. The American Cancer Society estimated that, the sensitivity of a PSA levels cutoff of 4.0 ng/mL, was twenty one percent for detecting any prostate cancer and fifty one percent for detecting high-grade cancers (Gleason ≥8). Validity of the test can be determined by the ability of its screening to accurately identify, if the patient has the disease or not. With PSA screening alone, one cannot validate if the patient has prostate cancer and other diagnostic tests such as digital rectal exam

Cervical cancer is one of the highly popular disease for the women. Different programmes has been made up to fight against this deadly disease. New Zealand has one of the best screening programmes in the world. The establishment of National Cervical Cancer Screening Programme in NZ in 1990 had reduced a significant number of 60% of women who develop cervical cancer and who die from it since it was built. More than 1 million New Zealander women are enrolled in this programme and 95 % are eligible. The Cervical Cancer screening programme aims to; informing women about the importance of having the cervical screening tests; promoting cervical screening tests on a regular basis to women aged 20–70; ensuring high-quality and culturally appropriate services; supporting women with abnormal tests; ensuring there is regular monitoring to see that the goals of the programme are being met. The NCSP also acknowledges the importance of the Treaty of Waitangi in providing a screening programme that is successful for all New Zealand women.