Prostate news article, January 2006
LETTER TO THE EDITOR OF THE TIMES Professor Roger S Kirby Visiting Professor to St George's Hospital, London |
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I was disappointed to read the uncritical report on the value of prostate specific antigen (PSA) testing in the Times 10th January. The negative results of one small case control study should not have been portrayed as the death knell for this blood test which in fact provides an invaluable aid to the diagnosis, staging and monitoring response to treatment of prostate cancer. Small studies such as these are of limited value and notoriously unreliable. The results of much larger on-going trials will be needed before we can truly assess the value of PSA as a tool for screening for prostate cancer.
In the meantime prostate cancer kills 10,000 men each year (4 every hour) and new cases in the UK rose by 50% between 1996 and 2001. It is an indisputable fact that the lower the PSA value is at the time of diagnosis the better is the eventual outlook is for the patient. Recent studies suggest that it is the rate of change of PSA over time rather than a one-off value that is of the greatest diagnostic and prognostic value. Actively discouraging men from being tested is only likely to delay the diagnosis and increase the mortality from prostate cancer, which, as the Committee for Public Account recently acknowledged, “is regarded as a lower priority than other common cancers when it comes to the provision of specialist care”.
Roger Kirby