{"id":2649,"date":"2015-01-31T18:29:30","date_gmt":"2015-01-31T07:29:30","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=2649"},"modified":"2015-01-31T18:29:30","modified_gmt":"2015-01-31T07:29:30","slug":"on-psa-testing","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=2649","title":{"rendered":"On PSA Testing"},"content":{"rendered":"<p>http:\/\/www.australiandoctor.com.au\/opinions\/guest-view\/why-do-doctors-keep-silent-about-their-own-prostat<\/p>\n<p>Simon Chapman&#8217;s ebook:\u00a0<a href=\"http:\/\/blog.panicola.com\/wp-content\/uploads\/2015\/01\/Let-sleeping-dogs-lie.pdf\">Let-sleeping-dogs-lie<\/a><\/p>\n<p>http:\/\/www.australiandoctor.com.au\/news\/latest-news\/nhrmc-finally-releases-its-psa-advice<\/p>\n<table border=\"1\" cellspacing=\"1\" cellpadding=\"1\">\n<tbody>\n<tr>\n<td><strong>For every 1000 low-risk, 60-year-old men tested annually over a decade:<\/strong><\/p>\n<ul>\n<li>Two will avoid dying of prostate cancer before age 85<\/li>\n<li>Two will avoid metastatic prostate cancer before age 85<\/li>\n<li>87 will have a false-positive test leading to an unnecessary biopsy, and 28 will suffer significant side effects as a result<\/li>\n<li>28 will be &#8220;overdiagnosed&#8221; with a prostate cancer that would likely otherwise have remained asymptomatic<\/li>\n<li>25 will be &#8220;overtreated&#8221;, 7-10 of whom will be left impotent or incontinent as a result<\/li>\n<li>PSA testing has &#8220;no discernible effect&#8221; on overall mortality<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The figures are largely unchanged from a draft version\u00a0<a href=\"http:\/\/www.australiandoctor.com.au\/news\/latest-news\/psa-testing-not-a-life-saver-nhmrc\" target=\"_blank\">released last <\/a><\/p>\n<header>\n<h1>Not sure what to say about PSA testing?<\/h1>\n<p class=\"small\"><span class=\"publishdate\"><time datetime=\"2014-03-05\">5 March, 2014<\/time><\/span> <span class=\"byline\"><a href=\"http:\/\/www.australiandoctor.com.au\/author\/David%20Brill\" data-callout-articles=\"1303\" data-callout=\"profile\" data-callout-name=\"David Brill\" data-callout-image=\"\" data-callout-google=\"\" data-original-title=\"\">David Brill<\/a><\/span> <span class=\"commentcount\"><a href=\"http:\/\/www.australiandoctor.com.au\/News\/Latest-News\/NHRMC-finally-releases-its-PSA-advice#disqus_thread\">6<\/a><a href=\"http:\/\/www.australiandoctor.com.au\/news\/latest-news\/nhrmc-finally-releases-its-psa-advice#comments\"> comments<\/a><\/span><\/p>\n<div id=\"sharing\">\n<div class=\"addthis_toolbox addthis_default_style\">\n<div class=\"fb-like fb_iframe_widget\" data-ref=\".VMyCMKHjMpQ.like\" data-layout=\"button_count\" data-show_faces=\"false\" data-action=\"like\" data-width=\"90\" data-font=\"arial\" data-href=\"http:\/\/www.australiandoctor.com.au\/news\/latest-news\/nhrmc-finally-releases-its-psa-advice\" data-send=\"false\">The NHMRC has finalised its PSA testing advice for doctors, in what is claimed to be the best summary of the evidence to date.<\/div>\n<\/div>\n<\/div>\n<\/header>\n<div id=\"bodycontent\">\n<div class=\"content\">\n<p>Released Tuesday, <a href=\"http:\/\/www.nhmrc.gov.au\/guidelines\/publications\/men4\" target=\"_blank\">the document provides a backgrounder<\/a> for GPs to discuss both the benefits and harms of PSA testing with asymptomatic men.<\/p>\n<p>Following an extensive literature review, with input spanning general practice, urology and oncology, the guide provides a list of statistics to use in conversation with patients (see below box).<\/p>\n<p>Professor Ian Olver (pictured), a member of the NHMRC&#8217;s expert advisory group, said the group was &#8220;as confident as we can be&#8221; in the figures.<\/p>\n<p>&#8220;We&#8217;re trying to say that the reason this can&#8217;t be promoted as a population test for everyone is that there are benefits and risks that have to be balanced. Every man has to decide where that balance lies for him,&#8221; said Professor Olver, CEO of the Cancer Council Australia.<\/p>\n<p>&#8220;We&#8217;re providing an evidence-based tool for practitioners to be able to have that discussion.&#8221;<\/p>\n<table border=\"1\" cellspacing=\"1\" cellpadding=\"1\">\n<tbody>\n<tr>\n<td><strong>For every 1000 low-risk, 60-year-old men tested annually over a decade:<\/strong><\/p>\n<ul>\n<li>Two will avoid dying of prostate cancer before age 85<\/li>\n<li>Two will avoid metastatic prostate cancer before age 85<\/li>\n<li>87 will have a false-positive test leading to an unnecessary biopsy, and 28 will suffer significant side effects as a result<\/li>\n<li>28 will be &#8220;overdiagnosed&#8221; with a prostate cancer that would likely otherwise have remained asymptomatic<\/li>\n<li>25 will be &#8220;overtreated&#8221;, 7-10 of whom will be left impotent or incontinent as a result<\/li>\n<li>PSA testing has &#8220;no discernible effect&#8221; on overall mortality<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The figures are largely unchanged from a draft version\u00a0<a href=\"http:\/\/www.australiandoctor.com.au\/news\/latest-news\/psa-testing-not-a-life-saver-nhmrc\" target=\"_blank\">released last year<\/a>, although the NHMRC has now stressed that the document &#8220;is not a substitute for relevant clinical practice guidelines and therefore does not contain recommendations&#8221;.<\/p>\n<p>Meanwhile, GPs will have to wait until December for full consensus clinical practice guidelines, which are <a href=\"http:\/\/www.prostate.org.au\/articleLive\/pages\/PCFA-reinforces-position-on-prostate-cancer-testing%252d-response-to-latest-RACGP-guidelines.html\" target=\"_blank\">currently being developed<\/a> by the Cancer Council Australia and Prostate Cancer Foundation of Australia.<\/p>\n<p>These guidelines also have broad, multidisciplinary representation, and it is hoped they will provide some resolution to a debate that has divided Australia&#8217;s medical colleges in recent years.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>http:\/\/www.australiandoctor.com.au\/opinions\/guest-view\/why-do-doctors-keep-silent-about-their-own-prostat Simon Chapman&#8217;s ebook:\u00a0Let-sleeping-dogs-lie http:\/\/www.australiandoctor.com.au\/news\/latest-news\/nhrmc-finally-releases-its-psa-advice For every 1000 low-risk, 60-year-old men tested annually over a decade: Two will avoid dying of prostate cancer before age 85 Two will avoid metastatic prostate cancer before age 85 87 will have a false-positive test leading to an unnecessary biopsy, and 28 will suffer significant side effects as a &hellip; <a href=\"https:\/\/blog.panicola.com\/?p=2649\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">On PSA Testing<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33,9,10],"tags":[],"class_list":["post-2649","post","type-post","status-publish","format-standard","hentry","category-health-market-quality","category-healthcare","category-healthy-habits"],"_links":{"self":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2649","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2649"}],"version-history":[{"count":1,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2649\/revisions"}],"predecessor-version":[{"id":2652,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/2649\/revisions\/2652"}],"wp:attachment":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2649"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2649"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2649"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}