If you truly wanna know just how confusing the PSA
screening (that’s the blood test to screen for prostate cancer) muddle can
be, and if you have the patience to
wade through the often cumbersome writing, then get ahold of the recent issue
of the New England Journal of Medicine, although you might first want to
fortify yourself with a tranquilizer or a big glass of wine (not both, though,
because the negative effects on alertness are additive).
Basically, what the authors have done is try to make this
issue much more understandable, to eliminate some of the confusion, but what
they’ve really managed to do, I think, is make it even harder for an individual
to figure out what to do about screening.
So while the authors conclude that having regular PSA
screening up to the age of 69 can – on average - add a few years of life to the
men in a large population of guys that age (as Homer Simpson says, “That’s
good”), they also add that the harm to a lot of men from over-treatment and
over diagnosis can really detract from the quality of the extra time they get
(Homer: “That’s bad.”)
And unfortunately,
we don’t really know – there’s no way to gauge ahead of time – whether
you will be one of the lucky guys whose life is extended by 6-8 good quality
years or one of the guys whose life is not extended, perhaps even shortened,
and who ends up ruing the day he got his PSA measured.
This study, in other words, changes very little: it’s
still an every-man-for-himself decision, with no good formula, actually no
formula at all, to follow.
