and politician Kari Parman writes in a letter to the editor of the DN’s Opinion that it is incomprehensible that we have not introduced pappografi than. But there are several reasons, including a significant överdiagnostik and the fact that the deaths have not decreased despite the voluntary PSA screening.
the Discussion of pappografi, or general screening for prostate cancer through the PSA test, has been consistent where the arguments are mainly concerned about the possibility of early detection and the gender dimension in that we have mammography for women. But there are reasons that the disadvantages outweigh the advantages.
Generally applicable screening, you talk about the number of people that need to be addressed in order to save a person. A european study involving 300,000 men, found that PSA screening is these figures that the 1.410 needed to be screened, of which 48 needed to be treated to save the life of a person. Aside the economic aspect, to treat 48 men unnecessarily is also the ethical dilemma to provide these 48 men impotence and incontinence problems (common side effects) to save a person.
then do everything possible to save the of about 2,400 men that die each year from prostate cancer? Yes, but we should also be aware that this figure is largely unchanged in the last ten years, despite the fact that the number of diagnoses through the voluntary PSA screening increased greatly.
the PSA-screening means that we produces far more the shocking news that they have cancer, but not able to save more. This is because a significant proportion of men have prostate cancer, but relatively few will develop symptomatic disease.
Obduktionsstudier shows, for example, that slightly more than half of all 80-year-olds who died from other causes have prostate cancer. At the same time, the calculations indicate that only 10 percent of the 80-year-olds have or will develop symptomatic prostate cancer.
through the PSA test would, of course, mean that we found more cases of cancer. But the absolute majority of these are cases without screening the patient would never been annoyed by.
Now forced him instead to undergo a mentally dizzying process to get being given a cancer diagnosis and subsequently undergo extensive treatment with high risk will lead to impotence or incontinence. Or, which mentally can be even harder, get to the oncology to get the news that we only wait and follow your cancer when it is in a so early stage that we do not need to do anything.
The day we can supplement the PSA test with other methods to reduce the överdiagnostiseringen (promising studies are underway, including in Stockholm) can the screening test be an option, but before then, we will just expose a significant proportion of men for the side effects, but to save more life.
Finally a few words about the gender perspective. Although mammography is a survey, in recent years, begun to question, in particular with a view to a comprehensive Danish study that found that mammography did not reduce the number of serious cases, but greatly increased the diagnosis of less severe cases. So roughly the same problem as with the proposed pappografin.
